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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
PubMed

Insights

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.

Keywords:
end of life decisions (geriatric medicine)infectionspneumonia (respiratory medicine)stroke

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