Multiple Cervical Artery Dissections Following COVID-19 Infection: A Case Report

Abstract

Cervical artery dissection is an uncommon but important cause of ischemic stroke in young adults. Severe cough or infection may precipitate arterial injury through mechanical stress or inflammation. We report the case of a 35-year-old man who presented with sudden severe posterior neck pain and headache after severe coughing during COVID-19. Brain magnetic resonance imaging (MRI) and angiography revealed infarction of the left middle cerebral artery and stenosis of the left carotid and vertebral arteries with aneurysmal dilatation. Vessel wall MRI revealed intramural hematomas in the left internal carotid artery and both vertebral arteries, confirming the diagnosis of multiple arterial dissections. The patient was treated with dual antiplatelet therapy, and his clinical condition subsequently improved. This case highlights that a cough associated with COVID-19 may trigger cervical artery dissection and that vessel wall MRI helps detect intramural hematomas in the subacute phase.