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    Massive cerebral venous thrombosis HP cerebral venous thrombosis MESHD related to oligosymptomatic COVID-19 infection: a case report

    Authors: Simone Beretta; Fulvio Da Re; Valentina Francioni; Paolo Remida; Benedetta Storti; Lorenzo Fumagalli; Maria Luisa Piatti; Patrizia Santoro; Diletta Cereda; Claudia Cutellè; Fiammetta Pirro; Danilo Antonio Montisano; Francesca Beretta; Francesco Pasini; Annalisa Cavallero; Ildebrando Appollonio; Carlo Ferrarese

    doi:10.21203/rs.3.rs-49755/v1 Date: 2020-07-27 Source: ResearchSquare

    Background: The development of thrombotic coagulopathy MESHD is frequent in COVID-19 patients, but the timing after infection, cerebral venous system involvement MESHD, treatment and outcome are uncertain.Case Presentation: We report a case of massive cerebral venous thrombosis HP cerebral venous thrombosis MESHD occurring in the late phase of COVID-19 infection MESHD. Mild respiratory symptoms, without fever HP, started three weeks before headache HP headache MESHD and acute neurological deficits MESHD. She had no dyspnea HP dyspnea MESHD, although she was hypoxic MESHD and with typical COVID-19 associated interstitial pneumonia MESHD pneumonia HP. Brain CT scan showed a left parietal hypodense lesion with associated sulcal subarachnoid haemorrhage MESHD. CT angiography showed a massive cerebral vein thrombosis MESHD. An asymptomatic TRANS concomitant right internal iliac vein thrombosis MESHD was found. Both cerebral venous thrombosis HP cerebral venous thrombosis MESHD and deep venous thrombosis HP deep venous thrombosis MESHD were effectively treated with unfractionated heparin started on the day of admission, then shifted to low molecular weight heparin, with a favorable clinical course. Nasopharyngel swab, repeated twice, tested negative for SARS-CoV-2. Serological tests SERO confirmed SARS-CoV-2 infection MESHD. Conclusions: Our case supports active surveillance and prevention of thrombotic complications MESHD associated with COVID-19, which may affect both peripheral and cerebral venous system MESHD. Early initiation of unfractionated heparin may lead to good neurological outcome.

    COVID-19 and Ischemic Stroke HP Stroke MESHD

    Authors: Amira Sidig; Khabab Abbasher; Hussien Abbasher; Radi Tofaha Alhusseini; Mohamed Elsayed; Mohammed Abbasher; Sufian Khalid M. N; Khalid Hajnoor; Mohammed Malekaldar; Mutaz F. Digna; Abbasher Hussien; Omer Eladil A. Hamid

    doi:10.21203/rs.3.rs-49338/v1 Date: 2020-07-26 Source: ResearchSquare

    Background: SARS-CoV-2 causes COVID-19 disease. It was identified in December 2019 and rapidly evolved into a pandemic. During the outbreak of COVID-19, researches demonstrated its effect on many systems, including the nervous system. In our clinic, we have reported an impact of SARS-CoV-2, causing the ischaemic stroke MESHD stroke HP.Case Report: A 62-year-old Sudanese male TRANS with some comorbidities brought to the A&E with fever HP fever MESHD, chest symptoms MESHD, and acute evolving left-sided hemiplegia HP hemiplegia MESHD power grade 0/5 MRCS with left upper motor neuron facial palsy HP facial palsy MESHD. Investigations: CT brain: right middle cerebral artery MCA infarction MESHD. CT- chest: bilateral ground-glass appearance. COVID-19 Test was positive. elevated D-dimer and C-reactive protein.Discussion: A retrospective study of data from the COVID-19 outbreak in China showed that the incidence of stroke HP stroke MESHD among hospitalized patients was approximately 5%. The fact that COVID-19 is an acute inflammatory condition associated with an increased incidence of fatty plaques formation, injury of the vascular wall, and hypercoagulability HP hypercoagulability MESHD, causing brain infarct MESHD can be a reasonable hypothesis.ConclusionPatients with COVID-19 are at increased risk of thrombo-embolization MESHD, leading to arterial and venous cerebrovascular accident MESHD. This case report enhances the importance of further studies to clarify the relationship between stroke HP stroke MESHD and COVID-19.

    Mechanical Thrombectomy of Large Vessel Occlusions MESHD in COVID-19 Related Stroke HP Stroke MESHD: Endovascular and Clinical Outcomes

    Authors: Anas S. Al-Smadi; Srishti Abrol; Ali Luqman; Parthasarathi Chamiraju; Hani Abujudeh

    doi:10.21203/rs.3.rs-49068/v1 Date: 2020-07-25 Source: ResearchSquare

    Background and PurposeStroke is a drastic complication and a poor prognostic marker of COVID-19 disease which emphasizes the importance of early identification and management of this complication. In this case series, we describe our experience of mechanical thrombectomy of large vessel occlusions (LVO) in patients with COVID-19.MethodsWe performed a retrospective study of a series of confirmed COVID-19 patients who underwent endovascular thrombectomy for acute cerebrovascular ischemic disease MESHD with large vessel occlusion. Patient demographics, presentations, lab values, angiographic and clinical outcomes were also reviewed.ResultsThree COVID-19 patients with large vessel occlusion who underwent endovascular thrombectomy were identified in our multi-center institution. Two patients had respiratory symptoms prior presentation and one patient presented initially with clinical deficits. Two patients had anterior circulation occlusion MESHD in the middle cerebral artery territory vs one had posterior circulation occlusion in the basilar artery. There was good angiographic outcome post thrombectomy in all patients, however poor clinical outcomes noted with no significant improvement in neurological manifestations in comparison with baseline at presentation.  All patients developed critically severe symptoms during hospitalization requiring intubation and one patient died of COVID-19 related respiratory failure HP respiratory failure MESHD.ConclusionIn this small case series, we noted worse clinical outcomes in COVID-19 related LVO stroke HP stroke MESHD despite effective thrombectomy, which may be related to the underlying COVID-19 disease and/or the nature of clot in these patients.

    Acutely Altered Mental Status as the Main Clinical Presentation of Multiple Strokes HP Strokes MESHD in Critically Ill Patients With COVID-19.

    Authors: Carolina Díaz-Pérez; Carmen Ramos; Alberto López-Cruz; José Muñoz Olmedo; Jimena Lázaro González; Enrique de Vega-Ríos; Carmen González-Ávila; Carlos Hervás; Santiago Trillo; José Vivancos

    doi:10.21203/rs.3.rs-31769/v1 Date: 2020-05-26 Source: ResearchSquare

    Background and aims: Cerebral infarction MESHD in COVID-19 patients might be associated with a hypercoagulable state related to a systemic inflammatory response. Its diagnosis might be challenging. We present two critically ill patients with COVID-19 who presented acutely altered mental status as the main manifestation of multiple strokes MESHD strokes HP.Methods:Clinical presentation and diagnostic work-up of the patients.Results:Two patients in their sixties were hospitalized with a bilateral pneumonia HP COVID-19. They developed respiratory failure HP respiratory failure MESHD and were admitted to ICU for mechanical ventilation and intense medical treatment. They were started on low-molecular-weight heparin since admission. Their laboratory results showed lymphopenia HP lymphopenia MESHD and increased levels of C-reactive protein and D-dimer. Case 1 developed hypofibrinogenemia HP and presented several cutaneous lesions with biopsy features of thrombotic vasculopathy MESHD. Case 2 was performed a CT pulmonary angiogram at ICU showing a bilateral pulmonary embolism HP pulmonary embolism MESHD. When waking up, both patients were conscious but with a remarkable global altered mental status without focal neurological deficits MESHD. A brain MRI revealed multiple acute bilateral ischemic lesions MESHD with areas of hemorrhagic MESHD transformation in both patients (Case 1: affecting the left frontal and temporal lobes MESHD and both occipital lobes; Case 2: affecting both frontal and left occipital lobes). Cardioembolic source and acquired antiphospholipid syndrome MESHD were ruled out. COVID-19-associated coagulopathy MESHD was suspected as the possible main etiology of the strokes HP strokes MESHD.Conclusion:Acutely altered mental status might be the main manifestation of multiple brain infarctions MESHD in critically ill COVID-19 patients. It should be specially considered in those with suspected COVID-19-associated coagulopathy MESHD. Full-dose anticoagulation and clinical-radiological monitoring might reduce their neurological consequences.

The ZB MED preprint Viewer preVIEW includes all COVID-19 related preprints from medRxiv and bioRxiv, from ChemRxiv, from ResearchSquare, from arXiv and from Preprints.org and is updated on a daily basis (7am CET/CEST).
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