Acute confusional state as a prognostic sign of COVID-19 large-vessel occlusion (LVO).
BMJ Case Rep
; 14(2)2021 Feb 23.
Article
in English
| MEDLINE | ID: covidwho-1099753
ABSTRACT
COVID-19 is well known for its respiratory symptoms, but severe presentations can alter haemostasis, causing acute end-organ damage with poor outcomes. Among its various neurological presentations, cerebrovascular events often present as small-vessel strokes. Although uncommon, in predisposed individuals, large-vessel occlusions (LVOs) can occur as a possible consequence of direct viral action (viral burden or antigenic structure) or virus-induced cytokine storm. Subtle presentations and complicated stroke care pathways continue to exist, delaying timely care. We present a unique case of COVID-19 LVO manifesting as an acute confusional state in an elderly man in April 2020. CT angiography revealed 'de novo' occlusions of the left internal carotid artery and proximal right vertebral artery, effectively blocking anterior and posterior circulations. Delirium can lead to inaccurate stroke scale assessments and prolong initiation of COVID-19 stroke care pathways. Future studies are needed to look into the temporal relationship between confusion and neurological manifestations.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Stroke
/
Delirium
/
COVID-19
Type of study:
Case report
/
Prognostic study
Topics:
Long Covid
Limits:
Aged
/
Humans
/
Male
Language:
English
Year:
2021
Document Type:
Article
Affiliation country:
Bcr-2020-240536
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