Acute cerebrovascular disease, particularly ischaemic stroke, has emerged as a serious complication of COVID-19. However, the mechanism and optimal management of this remain incompletely understood. In the pulmonary and cardiac circulation, there is evidence that thrombotic complications may relate to endothelial inflammation and injury but evidence for this in the cerebrovascular system is limited. In this paper, recently published in the Journal of Neurology, Neurosurgery and Psychiatry, the authors demonstrate direct imaging evidence of vasculitis in a patient with COVID-19 complicated by multiple territory ischaemic strokes which responded to steroids and targeted interleukin-1 (IL-1) and interleukin-6 (IL-6) inhibition.
