A case of cerebellar stroke/Wallenberg syndrome postx-COVID-19 infection

Abstract

Stroke has been reported as one of the several deadliest complications noted in COVID-19 infection. Stroke in COVID-19 is multifactorial and has propensity to involve large vessels and multiple territories. The most appealing mechanisms for strokes in COVID infection are the cytokine-induced coagulopathy and the endotheliopathy triggered by the infection. Stroke in young patients has been particularly observed. The treatment is also challenging in terms of judicious use of antithrombotic/anticoagulation agents concomitant to oral or intravenous steroids administration. We report a case of cerebellar stroke/ Wallenberg syndrome in a diagnosed COVID-19 patient with deranged coagulation profile and elevated interleukin-6. She presented with binocular diplopia, oscillopsia and had a very well documented skew deviation with torsional nystagmus. She also had impaired cerebellar functions. We also highlight the characteristic features of COVID stroke, its management, and shed light on the diagnosis of skew deviation and its management.