Intracranial hemorrhage in critically ill patients hospitalized for COVID-19.

Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia
Islam FayedJeffrey C Mai

Abstract

In this study, we report three cases of spontaneous intracranial hemorrhage in patients who were initially hospitalized at our tertiary care center in Washington, DC with symptoms of COVID-19. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was diagnosed in all three patients, who were critically ill, requiring intubation and ventilatory support. During their protracted hospitalizations, subsequent imaging disclosed intracranial hemorrhages, including intracerebral and subarachnoid hemorrhages, in the context of anticoagulation and coagulopathy. We believe this is related to the tropism of SARS-CoV-2 to the endothelial lining of the cerebral vasculature via their angiotensin-converting enzyme (ACE) II receptors. Given our findings, we advocate heightened vigilance for intracerebral hemorrhage events, and scanning when practicable, in COVID-19 patients which have prolonged ventilatory support and depressed neurologic examinations.

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Citations

Jan 24, 2021·Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology·Azalea T PajoRoland Dominic G Jamora
Feb 10, 2021·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Yoshimi ShinoharaJunkoh Yamamoto
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Jun 14, 2021·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Nikolaos Panagiotis MargosJohn Ellul
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Methods Mentioned

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