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

AuthorBjörn Sommeren
AuthorChristoph Maureren
AuthorAnsgar Berlisen
AuthorEhab Shibanen
Issued Date2021-07-31en
AbstractIntroduction: 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. In these patients, combined maximum surgical and endovascular therapy is needed.en
DOIhttps://doi.org/10.5812/ans.116184en
KeywordCOVID-19en
KeywordInfectionen
KeywordIntracerebral Hemorrhageen
KeywordLate Vasospasmen
KeywordTreatmenten
PublisherBrieflandsen
TitleSpontaneous Intracerebral Hemorrhage and Delayed Cerebral Vasospasm in a Patient with COVID-19 Infectionen
TypeCase Reporten

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