COVID-19 and Decompressive Hemicraniectomy for Acute Ischemic Stroke.
Stroke
; 51(9): e215-e218, 2020 09.
Article
in English
| MEDLINE | ID: covidwho-636399
ABSTRACT
BACKGROUND AND PURPOSE:
Young patients with malignant cerebral edema have been shown to benefit from early decompressive hemicraniectomy. The impact of concomitant infection with coronavirus disease 2019 (COVID-19) and how this should weigh in on the decision for surgery is unclear.METHODS:
We retrospectively reviewed all COVID-19-positive patients admitted to the neuroscience intensive care unit for malignant edema monitoring. Patients with >50% of middle cerebral artery involvement on computed tomography imaging were considered at risk for malignant edema.RESULTS:
Seven patients were admitted for monitoring of whom 4 died. Cause of death was related to COVID-19 complications, and these were either seen both very early and several days into the intensive care unit course after the typical window of malignant cerebral swelling. Three cases underwent surgery, and 1 patient died postoperatively from cardiac failure. A good outcome was attained in the other 2 cases.CONCLUSIONS:
COVID-19-positive patients with large hemispheric stroke can have a good outcome with decompressive hemicraniectomy. A positive test for COVID-19 should not be used in isolation to exclude patients from a potentially lifesaving procedure.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Pneumonia, Viral
/
Brain Ischemia
/
Coronavirus Infections
/
Neurosurgical Procedures
/
Stroke
/
Decompressive Craniectomy
Type of study:
Observational study
/
Prognostic study
Topics:
Long Covid
Limits:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Language:
English
Journal:
Stroke
Year:
2020
Document Type:
Article
Similar
MEDLINE
...
LILACS
LIS