COVID-19感染患者自发性脑出血和迟发性脑血管痉挛1例

IF 0.4 Q4 NEUROSCIENCES

Archives of Neuroscience Pub Date : 2021-08-21 DOI:10.5812/ans.116184

B. Sommer, C. Maurer, A. Berlis, E. Shiban

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引用次数: 0

摘要

引言：严重急性呼吸系统综合征冠状病毒2型可能导致血管炎和血栓栓塞事件。我们报告了一例新冠肺炎患者自发性脑出血和延迟性脑血管痉挛的罕见病例。病例介绍：一名65岁男性因短暂昏迷被转移到急诊科。就诊前22小时，患者发烧39.5°C，伴有呼吸困难。最初的新冠肺炎PCR呈阳性。在意识清醒且无任何神经损伤的情况下，检测到大面积右额脑出血（ICH）。术前血管造影显示无病理性血管或血管痉挛。由于脑出血进展，患者出现全身强直-阵挛性发作，导致立即用显微外科切除脑出血。13天后，病人再次昏迷。血管造影显示严重的脑血管痉挛（CV），需要重复经皮腔内血管成形术（PTA）和动脉内尼莫地平治疗。结论：我们报告了第一例与新冠肺炎相关的脑出血和延迟性血管痉挛。

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Spontaneous Intracerebral Hemorrhage and Delayed Cerebral Vasospasm in a Patient with COVID-19 Infection

Introduction: The SARS-CoV-2 may cause vasculitis and thromboembolic events. We report on an unusual case of spontaneous intracerebral hemorrhage and delayed cerebral vasospasms in a patient with COVID-19. Case Presentation: A 65-year-old male was transferred to the emergency department due to a short period of unconsciousness. Twenty-two hours prior to presentation, the patient had a 39.5°C fever with breathing difficulties. Initial COVID-19 PCR was positive. While conscious and without any neurological impairment, a large right frontal intracerebral hemorrhage (ICH) was detected. A preoperative angiogram showed no pathological blood vessels or vasospasm. The patients had a generalized tonic-clonic seizure due to ICH progression, which led to an immediate microsurgical ICH removal. Thirteen days thereafter, the patient became unconscious again. Angiography revealed severe cerebral vasospasm (CV) that required repetitive percutaneous transluminal angioplasty (PTA) and intra-arterial nimodipine treatment. Conclusions: We present the first case of ICH and delayed vasospasm associated with COVID-19.

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Archives of Neuroscience NEUROSCIENCES-

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期刊介绍： Archives of neuroscience is a clinical and basic journal which is informative to all practitioners like Neurosurgeons, Neurologists, Psychiatrists, Neuroscientists. It is the official journal of Brain and Spinal Injury Research Center. The Major theme of this journal is to follow the path of scientific collaboration, spontaneity, and goodwill for the future, by providing up-to-date knowledge for the readers. The journal aims at covering different fields, as the name implies, ranging from research in basic and clinical sciences to core topics such as patient care, education, procuring and correct utilization of resources and bringing to limelight the cherished goals of the institute in providing a standard care for the physically disabled patients. This quarterly journal offers a venue for our researchers and scientists to vent their innovative and constructive research works. The scope of the journal is as far wide as the universe as being declared by the name of the journal, but our aim is to pursue our sacred goals in providing a panacea for the intractable ailments, which leave a psychological element in the daily life of such patients. This authoritative clinical and basic journal was founded by Professor Madjid Samii in 2012.