scholarly journals Spontaneous Intracerebral Hemorrhage and Delayed Cerebral Vasospasm in a Patient with COVID-19 Infection

2021 ◽  
Vol 8 (3) ◽  
Author(s):  
Björn Sommer ◽  
Christoph Maurer ◽  
Ansgar Berlis ◽  
Ehab Shiban
Keyword(s):  
Intracerebral Hemorrhage ◽  
Cerebral Vasospasm ◽  
Neurological Impairment ◽  
Clonic Seizure ◽  
Transluminal Angioplasty ◽  
Spontaneous Intracerebral Hemorrhage ◽  
Case Presentation ◽  
Delayed Cerebral Vasospasm ◽  
First Case ◽  
Short Period

Introduction: The SARS-CoV-2 may cause vasculitis and thromboembolic events. We report on an unusual case of spontaneous intracerebral hemorrhage and delayed cerebral vasospasms in a patient with COVID-19. Case Presentation: A 65-year-old male was transferred to the emergency department due to a short period of unconsciousness. Twenty-two hours prior to presentation, the patient had a 39.5°C fever with breathing difficulties. Initial COVID-19 PCR was positive. While conscious and without any neurological impairment, a large right frontal intracerebral hemorrhage (ICH) was detected. A preoperative angiogram showed no pathological blood vessels or vasospasm. The patients had a generalized tonic-clonic seizure due to ICH progression, which led to an immediate microsurgical ICH removal. Thirteen days thereafter, the patient became unconscious again. Angiography revealed severe cerebral vasospasm (CV) that required repetitive percutaneous transluminal angioplasty (PTA) and intra-arterial nimodipine treatment. Conclusions: We present the first case of ICH and delayed vasospasm associated with COVID-19. In these patients, combined maximum surgical and endovascular therapy is needed.

scholarly journals Frequent Emergency Department Visits After Spontaneous Intracerebral Hemorrhage: Who Is at Risk?

2018 ◽  
Vol 8 (4) ◽  
pp. 166-170
Author(s):  
Jerina Nogueira ◽  
Pedro Abreu ◽  
Patrícia Guilherme ◽  
Ana Catarina Félix ◽  
Fátima Ferreira ◽  
...  
Keyword(s):  
At Risk ◽  
Emergency Department ◽  
Intracerebral Hemorrhage ◽  
Hospital Discharge ◽  
Transitional Care ◽  
Neurological Impairment ◽  
Emergency Department Visits ◽  
Spontaneous Intracerebral Hemorrhage ◽  
Increased Risk ◽  
Ed Visits

Background: The long-term prognosis of spontaneous intracerebral hemorrhage (SICH) is poor. Frequent emergency department (ED) visits can signal increased risk of hospitalization and death. There are no studies describing the risk of frequent ED visits after SICH. Methods: Retrospective cohort study of a community representative consecutive SICH survivors (2009-2015) from southern Portugal. Logistic regression analysis was performed to identify sociodemographic and clinical factors associated with frequent ED visits (≥4 visits) within the first year after hospital discharge. Results: A total of 360 SICH survivors were identified, 358 (98.6%) of whom were followed. The median age was 72; 64% were males. The majority of survivors (n = 194, 54.2%) had at least 1 ED visit. Reasons for ED visits included infections, falls with trauma, and isolated neurological symptoms. Forty-four (12.3%) SICH survivors became frequent ED visitors. Frequent ED visitors were older and had more hospitalizations ( P < .001) and ED visits ( P < .001) prior to the SICH, unhealthy alcohol use ( P = .049), longer period of index SICH hospitalization ( P = .032), pneumonia during hospitalization ( P = .001), and severe neurological impairment at discharge ( P = .001). Pneumonia during index hospitalization (odds ratio [OR]: 3.08; confidence interval [CI]: 1.39-6.76; P = .005) and history of ED visits prior to SICH (OR: 1.64; CI: 1.19-2.26, P = .003) increased the likelihood of becoming a frequent ED visitor. Conclusions: Predictors of frequent ED visits are identifiable at hospital discharge and during any ED visit. Improvement of transitional care and identification of at-risk patients may help reduce multiple ED visits.

scholarly journals Tension Pneumocephalus Related to Radiotherapy for Nasopharyngeal Carcinoma

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Esther Jimenez-Jimenez ◽  
Sebastià Sabater Martí ◽  
M. Victoria Villas
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Skull Base ◽  
Rare Complication ◽  
Altered Mental Status ◽  
Neurological Status ◽  
Neurological Impairment ◽  
Local Relapse ◽  
Case Presentation ◽  
Tension Pneumocephalus ◽  
First Case

Introduction.Tension pneumocephalus (TP) is a very rare complication related to radiotherapy for nasopharyngeal carcinoma (NPC).Case Presentation.A 46-year-old man was admitted to the hospital with an altered mental status and aqueous rhinorrhea for several hours of evolution. The computed tomography (CT) scan showed TP, a defect in the skull base and nasocranial fistula. The patient was receiving a second course of radiotherapy for local relapse. With medical treatment the patient recovered neurological status but died two days later.Discussion.In our knowledge, only 4 cases with similar characteristics have been reported in the literature. This is the first case report of TP during radiotherapy. TP was an abrupt and rapid process with neurological impairment for hours of evolution without suspicious osteoradionecrosis (OR) in previous scan images. The defect in the skull base could be due to a rapid disappearance of the tumor. The appearance of aqueous rhinorrhea and neurological symptoms must be viewed as signs of alarm.

scholarly journals Spontaneous Intracerebral Hemorrhage (ICH) associated with pregnancy and SARS-CoV-2 infection: a case report

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Parisa Dini ◽  
Soheila Aminimoghaddam ◽  
Zahra Mirzaasgari ◽  
Neda Rahimian ◽  
Samaneh Tanhapour Khotbehsara ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Multiorgan Failure ◽  
Pregnant Patient ◽  
Risk Groups ◽  
Pulmonary Complications ◽  
Spontaneous Intracerebral Hemorrhage ◽  
Case Presentation ◽  
Hemorrhagic Events ◽  
History Of

Abstract Background Coronavirus Disease 2019 (COVID-19) is predominately known as a respiratory disease associated with pneumonia, acute respiratory distress syndrome and multiorgan failure. However, extra-pulmonary complications of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are increasingly being recognized. In this regard, some studies implied the hemostatic and vascular involvements in patients with SARS-CoV-2 infection. Case presentation We describe a case of spontaneous Intracerebral Hemorrhage (ICH) in a pregnant patient with COVID-19 and history of cesarean section a week before the occurrence of ICH. The patient underwent emergent craniotomy with acceptable outcome. Hemorrhagic events, including ICH, may happen during COVID-19 infection with several possible mechanisms. Conclusion COVID-19 patients, especially high-risk groups, are at a risk of intracranial hemorrhage. Therefore, close follow-up must be maintained and hemorrhagic events must be kept in mind in these cases.

Fatal Community-Acquired Bloodstream Infection Caused By Klebsiella Variicola: A Case Report

2021 ◽  
Author(s):  
Dali Long ◽  
Yuhui Wang ◽  
Jinlong Wang ◽  
Sijie Mu ◽  
Li Chen ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Parasitic Infection ◽  
Drug Susceptibility ◽  
Klebsiella Pneumonia ◽  
Gene Detection ◽  
Case Presentation ◽  
First Case ◽  
Short Period ◽  
Genetic Detection

Abstract Background Klebsiella pneumoniae infection leads to significant concerns because of its varied manifestation and resultant mortality. While recent genetic structure analysis reveals that the higher virulence and mortality could be from its subspecies rather than Klebsiella pneumoniae. However, which is often misdiagnosed and underestimated in clinic because it’s difficult to distinguish Klebsiella pneumoniae from its subspecies using classic clinical examinations. This case study is the first in clinic to report the fast and fatal effect of Klebsiella subspecies, and serve as reference for doctors diagnosing similar diseases. Case presentation A 52-years male patient was admitted to hospital due to unknown high fever. All examinations excluded the viruses, fungi, mycoplasma/chlamydia and parasitic infection. Classic bacterial culture revealed the klebsiella pneumonia, however sensitive antibacterial adheres to drug susceptibility results failed to improve patient’s symptoms. His condition worsened and rapidly entered sepsis and subsequent sepsis shock, died within 72 hours of symptom onset. The PMseq-DNA Pro High throughput gene detection was acquired on second day after death revealing the mixed infection of klebsiella variicola and klebsiella pneumoniae. Clinic evidences suggested that Klebsiella variicola rather than klebsiella pneumoniae contributed to patient’s poor prognosis. Conclusions: This is the first case reported that patient died from klebsiella subspecies infection within short period of time. Which suggests that we should be alert to the clinical hazards and fatal effect of klebsiella subspecies. Classic method is limited in guiding the anti-infection therapy for complex cases, early genetic detection should be recommended in the diagnosis and management of complex infection.

Spontaneous Intracerebral Hemorrhage in the Elderly Population

2018 ◽  
Author(s):  
S. Sommaruga ◽  
R. Beekman ◽  
S. Chu ◽  
Z. King ◽  
C. Matouk ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Elderly Population ◽  
The Elderly ◽  
Spontaneous Intracerebral Hemorrhage

Spontaneous intracerebral hemorrhage in a child with systemic hypertension and adrenal adenoma

2007 ◽  
Vol 107 (4) ◽  
pp. 328-329
Author(s):  
Oszkar Szentirmai ◽  
Ken R. Winston ◽  
Paul Jedlicka ◽  
Gary M. Lum
Keyword(s):  
Intracerebral Hemorrhage ◽  
Adrenal Adenoma ◽  
Systemic Hypertension ◽  
Spontaneous Intracerebral Hemorrhage
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