Intracerebral haemorrhage in COVID-19

Most cases of SARS-CoV-2 infection are asymptomatic or have only mild respiratory symptoms. Patients with risk factors, including but not limited to advanced age, obesity, cardiovascular diseases and immunosuppression, may develop a severe course of disease due to the development of a cytokine storm. COVID-19 is associated with an increased risk of bleeding and thromboembolic complications, with the gastrointestinal tract and CNS being among the most frequent sites of bleeding. One of the causes of vessel wall rupture and subsequent bleeding in COVID-19 may be dysfunction of the damaged endothelium. Viral infections are one of the most potent triggers of autoimmune diseases. One of the possible causes of haemorrhagic stroke is virus-induced acute vasculitis.

Evolution of endovascular neurointerventional procedures numbers in czech republic between 2013 and 2020 years and literature survey of studies with the czech authorship or coauthorship

Aim: The authors analysed numbers of endovascular neurointerventional procedures in Czech Republic comprehensive neurovascular centres in the years from 2013 to 2020. Methods: The questionnaire was sent to all tertiary and two secondary neurovascular centres in Czech Republic. Numbers of each specified procedure were required. On basis of the 3 most frequently performed procedures (endovascular therapy of acute ischemic stroke, extra- and intracranial stenoses, and intracranial aneurysms) the eight-year trends of each procedure frequency, and total numbers of all neurovascular procedures (i.e. carotid dissections, intracranial stenoses, cerebral and spinal arteriovenous shunts, skull base tumors, epistaxis, vasospasms after subarachnoid hemorrhage) were evaluated. Results: Frequency of the mechanic thrombectomy increased from 417 procedures in the year 2013 to 1468 procedures in the year 2019. There was yearly increase of the number of procedures by 132 in 2017, by 154 in 2018, by 148 in 2019. In 2020 number of procedures for ischemic stroke decreased by 19. There was stagnation in numbers of carotid angioplasties, and treated cerebral aneurysms during the studied period. Conclusion: There were significant differences revealed among cerebrovascular centres regarding numbers of treated patiens for acute ischemic stroke, extra- and intracranial stenoses, and cerebral aneurysms. The number of neurovascular procedures decreased due to the SARS-CoV-2 pandemic in 2020.