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Arterial and venous strokes in the setting of COVID-19.
Kananeh, Mohammed F; Thomas, Tijo; Sharma, Kumud; Herpich, Franziska; Urtecho, Jacqueline; Athar, M Kamran; Jabbour, Pascal; Shah, Syed Omar.
  • Kananeh MF; Department of Neurological Surgery, Vickie and Jack Farber Institute for Neuroscience, Thomas Jefferson University, Philadelphia, PA, United States.
  • Thomas T; Department of Neurological Surgery, Vickie and Jack Farber Institute for Neuroscience, Thomas Jefferson University, Philadelphia, PA, United States.
  • Sharma K; Department of Neurological Surgery, Vickie and Jack Farber Institute for Neuroscience, Thomas Jefferson University, Philadelphia, PA, United States.
  • Herpich F; Department of Neurological Surgery, Vickie and Jack Farber Institute for Neuroscience, Thomas Jefferson University, Philadelphia, PA, United States.
  • Urtecho J; Department of Neurological Surgery, Vickie and Jack Farber Institute for Neuroscience, Thomas Jefferson University, Philadelphia, PA, United States.
  • Athar MK; Department of Neurological Surgery, Vickie and Jack Farber Institute for Neuroscience, Thomas Jefferson University, Philadelphia, PA, United States.
  • Jabbour P; Department of Neurological Surgery, Vickie and Jack Farber Institute for Neuroscience, Thomas Jefferson University, Philadelphia, PA, United States.
  • Shah SO; Department of Neurological Surgery, Vickie and Jack Farber Institute for Neuroscience, Thomas Jefferson University, Philadelphia, PA, United States. Electronic address: syed.o.shah@jefferson.edu.
J Clin Neurosci ; 79: 60-66, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-635053
Semantic information from SemMedBD (by NLM)
1. COVID-19 CAUSES Influenza-like symptoms
Subject
COVID-19
Predicate
CAUSES
Object
Influenza-like symptoms
2. Veins LOCATION_OF Infarction
Subject
Veins
Predicate
LOCATION_OF
Object
Infarction
3. Cerebral venous sinus thrombosis PREDISPOSES Cerebrovascular accident
Subject
Cerebral venous sinus thrombosis
Predicate
PREDISPOSES
Object
Cerebrovascular accident
4. Arteries LOCATION_OF Cerebrovascular accident
Subject
Arteries
Predicate
LOCATION_OF
Object
Cerebrovascular accident
5. Cerebrovascular accident COEXISTS_WITH Vascular occlusion
Subject
Cerebrovascular accident
Predicate
COEXISTS_WITH
Object
Vascular occlusion
6. Thrombophilia CAUSES Ischemic stroke
Subject
Thrombophilia
Predicate
CAUSES
Object
Ischemic stroke
7. Ischemic stroke PROCESS_OF Patients
Subject
Ischemic stroke
Predicate
PROCESS_OF
Object
Patients
8. Negative Regulation of Coagulation AFFECTS Patients
Subject
Negative Regulation of Coagulation
Predicate
AFFECTS
Object
Patients
9. COVID-19 CAUSES Influenza-like symptoms
Subject
COVID-19
Predicate
CAUSES
Object
Influenza-like symptoms
10. Veins LOCATION_OF Infarction
Subject
Veins
Predicate
LOCATION_OF
Object
Infarction
11. Cerebral venous sinus thrombosis PREDISPOSES Cerebrovascular accident
Subject
Cerebral venous sinus thrombosis
Predicate
PREDISPOSES
Object
Cerebrovascular accident
12. Arteries LOCATION_OF Cerebrovascular accident
Subject
Arteries
Predicate
LOCATION_OF
Object
Cerebrovascular accident
13. Cerebrovascular accident COEXISTS_WITH Vascular occlusion
Subject
Cerebrovascular accident
Predicate
COEXISTS_WITH
Object
Vascular occlusion
14. Thrombophilia CAUSES Ischemic stroke
Subject
Thrombophilia
Predicate
CAUSES
Object
Ischemic stroke
15. Ischemic stroke PROCESS_OF Patients
Subject
Ischemic stroke
Predicate
PROCESS_OF
Object
Patients
16. Negative Regulation of Coagulation AFFECTS Patients
Subject
Negative Regulation of Coagulation
Predicate
AFFECTS
Object
Patients
ABSTRACT
BACKGROUND AND

PURPOSE:

Coronavirus disease 2019 (COVID-19) is a global pandemic that causes flu-like symptoms. There is a growing body of evidence suggesting that both the central and peripheral nervous systems can be affected by SARS-CoV-2, including stroke. We present three cases of arterial ischemic strokes and one venous infarction from a cerebral venous sinus thrombosis in the setting of COVID-19 infection who otherwise had low risk factors for stroke.

METHODS:

We retrospectively reviewed patients presenting to a large tertiary care academic US hospital with stroke and who tested positive for COVID-19. Medical records were reviewed for demographics, imaging results and lab findings.

RESULTS:

There were 3 cases of arterial ischemic strokes and 1 case of venous stroke 3 males and 1 female. The mean age was 55 (48-70) years. All arterial strokes presented with large vessel occlusions and had mechanical thrombectomy performed. Two cases presented with stroke despite being on full anticoagulation.

CONCLUSIONS:

It is important to recognize the neurological manifestations of COVID-19, especially ischemic stroke, either arterial or venous in nature. Hypercoagulability and the cytokine surge are perhaps the cause of ischemic stroke in these patients. Further studies are needed to understand the role of anticoagulation in these patients.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Coronavirus Infections / Stroke / Betacoronavirus Type of study: Observational study / Prognostic study Topics: Long Covid Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: J Clin Neurosci Journal subject: Neurology Year: 2020 Document Type: Article Affiliation country: J.jocn.2020.07.005

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Coronavirus Infections / Stroke / Betacoronavirus Type of study: Observational study / Prognostic study Topics: Long Covid Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: J Clin Neurosci Journal subject: Neurology Year: 2020 Document Type: Article Affiliation country: J.jocn.2020.07.005