Intracranial hemorrhage in a young COVID-19 patient

Nicolas K. Khattar, Mayur Sharma, Abigail P. McCallum, Brent G. Oxford, Hassan Zeb, Sally A. Suliman, Emily P. Sieg, J. Mocco, Joseph S. Neimat, Ajmal Zemmar

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

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.

Original languageEnglish
Article number100878
JournalInterdisciplinary Neurosurgery: Advanced Techniques and Case Management
Volume22
DOIs
StatePublished - Dec 2020

Keywords

  • COVID-19
  • Coagulopathy
  • Inflammation
  • Intracerebral hemorrhage

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