Cerebrovascular accidents indicative of COVID-19 infection: about 4 observations in Guinea.

INTRODUCTION: Coronavirus is a virus with potential to target the nervous and respiratory systems. The aim of this work is to establish the prevalence of strokes in COVID19 positive patients in Guinea. METHODS: All patients with stroke confirmed by brain imaging and COVID-positive PCR were included in this study. Retrospective patient data were obtained from medical records. Informed consent was obtained. RESULTS: The RT-PCR confirmed the initial diagnosis and the chest CT scan provided a good diagnostic orientation. Brain imaging identified ischemic brain lesions. We report the case of four patients with stroke and a COVID-19 incidental finding in Guinea. CONCLUSION: This work shows that the onset of ischemic stroke associated with COVID-19 is generally delayed, but can occur both early and late in the course of the disease. More attention is needed because the early symptoms of viral attack are not just pulmonary.

Cerebrovascular accidents indicative of COVID-19 infection: about 4 observations in Guinea

Introduction: coronavirus is a virus with potential to target the nervous and respiratory systems. The aim of this work is to establish the prevalence of strokes in COVID19 positive patients in Guinea. Methods: all patients with stroke confirmed by brain imaging and COVID-positive PCR were included in this study. Retrospective patient data were obtained from medical records. Informed consent was obtained. Results: the RT-PCR confirmed the initial diagnosis and the chest CT scan provided a good diagnostic orientation. Brain imaging identified ischemic brain lesions. We report the case of four patients with stroke and a COVID-19 incidental finding in Guinea.Conclusion: this work shows that the onset of ischemic stroke associated with COVID-19 is generally delayed, but can occur both early and late in the course of the disease. More attention is needed because the early symptoms of viral attack are not just pulmonary

Epilepsy and traditional healers in the Republic of Guinea: A mixed methods study.

PURPOSE: The purpose of this study was to characterize the reasons, extent, and impact of traditional medicine use among people with epilepsy (PWE) in the Republic of Guinea. METHODS: Guinea is a low-income country in sub-Saharan Africa (SSA) with limited healthcare resources. People with epilepsy and their caregivers were seen at a public referral hospital in Conakry, the capital city, where they completed semi-structured interviews with physicians regarding their beliefs about epilepsy, medical care, and engagement with traditional healers. RESULTS: Of 132 participants (49% children, 44% female, 55% with a university-educated head of household), 79% had seen a traditional healer, and 71% saw a traditional healer before seeing a medical provider for their epilepsy. Participants were treated by a traditional healer for a mean of 39 months before seeing a medical provider. By contrast, 58% of participants reported taking antiepileptic drugs (AEDs) regularly; 46% reported having undergone a head computed tomography (CT) scan; 58% reported having had an electroencephalogram, and 4% reported having had a brain magnetic resonance imaging (MRI) scan. CONCLUSIONS: Traditional healers in Guinea provide frontline care for PWE in Guinea with considerable delays in AED initiation, even among a cohort of PWE actively seeking medical care. Engaging with these healers is critical for both influencing community perceptions and appropriately managing epilepsy throughout the country.

Transfusion related acute lung injury (TRALI) after plasma exchange in myasthenic crisis.

BACKGROUND: Transfusion-Related Acute Lung Injury (TRALI) is an uncommon but potentially fatal reaction that is both temporally and mechanistically related to receiving allogenic blood components. Although many patients with neurological disease receive plasma exchange, TRALI in a patient receiving plasma exchange for a neurological disease has not been previously reported. CASE: A 79-year-old woman with an 18-month history of myasthenia gravis, was treated with a 4-day course of plasma exchange for symptomatic control of ptosis, diplopia, generalized fatigue, and chewing difficulties. On her fourth day of receiving plasma exchange, she experienced sudden-onset chest heaviness, diaphoresis, and dyspnea with hypoxemia, unresolved by 5 l of oxygen via nasal cannulae. She was initially investigated for a myocardial infarction and pulmonary embolus, but these were ruled out. Chest radiograph demonstrated bilateral pulmonary edema and she was clinically diagnosed with TRALI. DISCUSSION: Although clinically identical to adult respiratory distress syndrome (ARDS), the association of TRALI with transfusion and its relatively lower mortality rate made it clinically distinct. Treatment is supportive, but patients who tolerate the initial reaction are likely to make full recovery within 72 h. Since prognosis can be excellent, identification and emergent management is essential, particularly in patients with comorbid neurological disease.