Intracranial hemorrhage and Covid-19: A retrospective analysis of 1675 hospitalized Covid-19 Brazilian patients.

Objective: The present study seeks to overcome the lack of data on Covid-19 associated intracranial hemorrhage (ICH) in Brazil. Methods: This is a retrospective, single-center case series of consecutive patients. It is a subanalysis of a larger study still in progress, which covers all neurological manifestations that occurred in patients admitted between March 1st, 2020 and June 1st, 2022, with active SARS-CoV-2 infection confirmed by polymerase chain reaction test. All patients with non-traumatic ICH were included. Results: A total of 1675 patients were evaluated: 917 (54.75 %) had one or more neurological symptoms and 19 had non-traumatic ICH, comprising an incidence of 1.13 %. All patients had one or more risk factors for ICH. The presence of neurological manifestations before the ICH and ICU admission showed a statistically significant relationship with the occurrence of ICH (X2 = 6.734, p = 0.0095; OR = 4.47; CI = 1.3-15.4; and FET = 9.13; p = <0.001; OR = 9.15; CI = 3.27-25.5 respectively). Conclusion: Our findings were largely congruent with the world literature. We believe that the assessment of risk factors can accurately predict the subgroup of patients at increased risk of ICH, but further studies are needed to confirm these hypotheses.

COVID-19 via intrauterine transmission in a critically ill preterm infant: A case report.

A preterm infant was born emergently at 29 weeks gestation to a mother with active coronavirus disease 2019 (COVID-19). Clinical presentation and evaluation were consistent with in utero transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The neonate experienced progressive, refractory respiratory failure and catastrophic intracranial hemorrhage which ultimately led to limitation of care.

Concurrent intracranial infarct and intraventricular hemorrhage with spontaneous nontraumatic extradural hemorrhage in follow-up: An enigma of COVID-19-associated intracranial vasculopathy.

Background: Several neurological manifestations have been described in the literature, in patients affected with COVID-19 infection. Some common forms include ischemic stroke, cardioembolic stroke, intraparenchymal hemorrhage, and multicompartmental hemorrhage. Concurrent brain infarct and intraventricular hemorrhage (IVH) have not been described in the literature previously. Case Description: A 35-year hypertensive and COVID-19-positive patient developed sudden-onset spontaneous IVH with concurrent infarct in the left internal capsule. In spite of undergoing an initial CSF drainage procedure, he had persistent worsening sensorium and increasing midline shift on CT imaging, so he underwent a left-sided decompressive craniectomy. One month after discharge, he developed spontaneous extradural hemorrhage at the operative site. In view of impending cerebral herniation, emergency hematoma evacuation was done, which restored his neurological status. Conclusion: This is the first reported detailed case of concurrent intracranial infarct and IVH in a patient affected with COVID-19 infection. We also report a rare phenomenon of nontraumatic noncoagulopathic extradural hemorrhage on the decompressive craniectomy site, in this patient 1 month after surgery.

COVID-19 outbreak as a probable cause of increased risk of intracranial rebleeding in partially treated cerebral arteriovenous malformations.

Patients who are infected with COVID-19 and have cerebral arteriovenous malformations which are partially treated or untreated may be more liable to rupture or bleed than not infected patients.