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Author Spotlight: Assessing Ischemic Stroke Damage Through Middle Cerebral Artery Occlusion Model
Published on: August 11, 2023
Ischemic stroke associated with novel coronavirus 2019: a report of three cases
Athena Sharifi-Razavi1, Narges Karimi2, Ashraf Zarvani1
1Clinical Research Development Unit of Bou Ali Sina Hospital, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
Insights
COVID-19 infection can cause severe ischemic stroke in adults. This study highlights three cases where coronavirus disease 2019 led to large cerebral artery involvement, emphasizing the need for prompt diagnosis.
Area of Science:
- Neurology
- Infectious Diseases
- Vascular Neurology
Background:
- Limited evidence exists on the neurological effects of COVID-19.
- This report details three adult patients experiencing ischemic stroke linked to SARS-CoV-2 infection.
Observation:
- Three adult patients presented with ischemic stroke symptoms, including hemiplegia, facial paresis, drowsiness, and aphasia.
- All patients tested positive for COVID-19 via RT-PCR.
- Clinical presentations included fever and respiratory issues preceding or coinciding with stroke onset.
Findings:
- COVID-19 infection was associated with severe ischemic stroke in these cases.
- All three patients exhibited involvement of large cerebral arteries.
- Two patients required intensive care unit (ICU) admission due to stroke severity.
Implications:
- The exact mechanism linking COVID-19 to ischemic stroke remains unclear, potentially involving inflammatory cytokines or direct arterial infection.
- COVID-19 vasculopathy should be considered in the differential diagnosis of ischemic strokes with unclear etiology during the pandemic.
- Early recognition and management of potential COVID-19-related neurological complications are crucial.
Introduction:
There is limited evidence about the neurological manifestations of COVID-19 in infected patients. In this report, we describe three patients with ischemic stroke associated with COVID-19 infection.
Methods:
We report 3 cases of adult patients with ischemic stroke and novel coronavirus 2019 infection. Case 1 is an 88-year-old female with acute left hemiplegia and right peripheral facial paresis that she had a fever along with stroke symptoms. Case 2 is an 85-year-old female with left hemiplegia and drowsiness who had a weakness, asthenia, and dry cough 3 days before appearing stroke signs. Case 3 is a 55-year-old male with acute Broca's aphasia and right hemiplegia who experience fever and respiratory problems 3 days after admission.
Results:
The clinical symptoms of infected patients with COVID-19 have been associated with severe symptoms of ischemic stroke. Two patients were admitted to the ICU. RT-PCR of the oropharyngeal sample was positive in three cases. All patients had the involvement of large cerebral arteries.
Conclusion:
The mechanism by which COVID-19 causes ischemic stroke is unknown but it is likely by production inflammatory cytokines or direct infection of cerebral arteries. Therefore, regarding the current situation of the COVID-19 pandemic, it is indispensable that the possible diagnosis of COVID-19 vasculopathy is considered in all ischemic strokes of unclear etiology.
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