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Massive bilateral stroke in a COVID-19 patient
Iskandar Zulqarnain Bin Mohamed1, Laura Balson1, Shyam Madathil2
1Respiratory Medicine Department, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
BMJ Case Reports
|August 21, 2020
Summary
Coronavirus disease 2019 (COVID-19) can cause severe stroke complications, including bilateral middle cerebral artery strokes. This case highlights the need for awareness of neurological complications in COVID-19 patients and further research into anticoagulation and stroke management.
Area of Science:
- Neurology
- Infectious Diseases
- Vascular Medicine
Background:
- Coronavirus disease 2019 (COVID-19) is a novel infectious disease with emerging evidence of vascular complications.
- Microvascular and macrovascular issues are significant contributors to morbidity and mortality in COVID-19 patients.
Observation:
- A case of a woman with COVID-19 presented with reduced consciousness.
- This was found to be due to massive, bilateral middle cerebral artery strokes.
Findings:
- COVID-19 is associated with severe cerebrovascular events, such as large artery strokes.
- Reduced consciousness in COVID-19 patients can be a symptom of stroke, necessitating a broad differential diagnosis.
Implications:
- Clinicians must consider stroke as a cause of altered consciousness in COVID-19 patients, especially when delirium does not fully explain the presentation.
- Urgent research is required on anticoagulation strategies and stroke management protocols for patients with COVID-19 to guide clinical practice.
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