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Intracranial hemorrhage in a young COVID-19 patient.
Khattar, Nicolas K; Sharma, Mayur; McCallum, Abigail P; Oxford, Brent G; Zeb, Hassan; Suliman, Sally A; Sieg, Emily P; Mocco, J; Neimat, Joseph S; Zemmar, Ajmal.
  • Khattar NK; Department of Neurosurgery, Henan Provincial People's Hospital, Henan University People's Hospital, Henan University School of Medicine, Zhengzhou, China.
  • Sharma M; Department of Neurological Surgery, University of Louisville School of Medicine, Louisville KY, USA.
  • McCallum AP; Department of Neurological Surgery, University of Louisville School of Medicine, Louisville KY, USA.
  • Oxford BG; Department of Neurological Surgery, University of Louisville School of Medicine, Louisville KY, USA.
  • Zeb H; Department of Neurological Surgery, University of Louisville School of Medicine, Louisville KY, USA.
  • Suliman SA; Department of Medicine, University of Louisville School of Medicine, Louisville, KY, USA.
  • Sieg EP; Department of Medicine, University of Louisville School of Medicine, Louisville, KY, USA.
  • Mocco J; Department of Neurological Surgery, University of Louisville School of Medicine, Louisville KY, USA.
  • Neimat JS; Department of Neurological Surgery, Mount Sinai Medical Center, New York, NY USA.
  • Zemmar A; Department of Neurological Surgery, University of Louisville School of Medicine, Louisville KY, USA.
Interdiscip Neurosurg ; 22: 100878, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-709592
Semantic information from SemMedBD (by NLM)
1. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
2. Intracranial Hemorrhage PROCESS_OF Patients
Subject
Intracranial Hemorrhage
Predicate
PROCESS_OF
Object
Patients
3. Cerebral Hemorrhage PROCESS_OF Patients
Subject
Cerebral Hemorrhage
Predicate
PROCESS_OF
Object
Patients
4. Dyspnea PROCESS_OF Patients
Subject
Dyspnea
Predicate
PROCESS_OF
Object
Patients
5. Fever PROCESS_OF Patients
Subject
Fever
Predicate
PROCESS_OF
Object
Patients
6. Thrombophilia COEXISTS_WITH Intubated
Subject
Thrombophilia
Predicate
COEXISTS_WITH
Object
Intubated
7. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
8. Intracranial Hemorrhage PROCESS_OF Patients
Subject
Intracranial Hemorrhage
Predicate
PROCESS_OF
Object
Patients
9. Cerebral Hemorrhage PROCESS_OF Patients
Subject
Cerebral Hemorrhage
Predicate
PROCESS_OF
Object
Patients
10. Dyspnea PROCESS_OF Patients
Subject
Dyspnea
Predicate
PROCESS_OF
Object
Patients
11. Fever PROCESS_OF Patients
Subject
Fever
Predicate
PROCESS_OF
Object
Patients
12. Thrombophilia COEXISTS_WITH Intubated
Subject
Thrombophilia
Predicate
COEXISTS_WITH
Object
Intubated
ABSTRACT
COVID-19 patients are increasingly understood to develop multisystem manifestations, including neurologic involvement. We report the case of a 42-year old COVID-19 positive patient with a fatal intracerebral hemorrhage (ICH). The patient presented with fever and dyspnea, requiring intubation due to medical complications. After prolonged sedation and anticoagulation, the patient suddenly developed bilaterally fixed and dilated pupils, caused by a right-sided intracranial hemorrhage with uncal herniation. The course of this case illustrates the delicate balance between hypercoagulability and coagulation factor depletion; especially in the intubated and sedated patient, in whom regular neurological assessments are impeded. As we expand our understanding of the neurological ramifications of COVID-19, clinicians need to be increasingly aware of the precarious coagulation balance.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Case report Language: English Journal: Interdiscip Neurosurg Year: 2020 Document Type: Article Affiliation country: J.inat.2020.100878

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Case report Language: English Journal: Interdiscip Neurosurg Year: 2020 Document Type: Article Affiliation country: J.inat.2020.100878