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

doi:10.1016/j.inat.2020.100878

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 journal › Article › peer-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 language	English (US)
Article number	100878
Journal	Interdisciplinary Neurosurgery: Advanced Techniques and Case Management
Volume	22
DOIs	https://doi.org/10.1016/j.inat.2020.100878
State	Published - Dec 2020
Externally published	Yes

Bibliographical note

Publisher Copyright:
© 2020 The Authors

Keywords

COVID-19
Coagulopathy
Inflammation
Intracerebral hemorrhage

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.inat.2020.100878

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title = "Intracranial hemorrhage in a young COVID-19 patient",

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 = "COVID-19, Coagulopathy, Inflammation, Intracerebral hemorrhage",

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

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AU - Khattar, Nicolas K.

AU - Sharma, Mayur

AU - McCallum, Abigail P.

AU - Oxford, Brent G.

AU - Zeb, Hassan

AU - Suliman, Sally A.

AU - Sieg, Emily P.

AU - Mocco, J.

AU - Neimat, Joseph S.

AU - Zemmar, Ajmal

PY - 2020/12

Y1 - 2020/12

N2 - 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.

AB - 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.

KW - COVID-19

KW - Coagulopathy

KW - Inflammation

KW - Intracerebral hemorrhage

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ER -

Intracranial hemorrhage in a young COVID-19 patient

Abstract

Bibliographical note

Keywords

UN SDGs

Publisher link

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