Clinic of Neurology, Sakarya University, Sakarya Training and Research Hospital, Sakarya, Turkey.
Clinic of Neurology, Sakarya University, Sakarya Training and Research Hospital, Sakarya, Turkey.
J Clin Neurosci. 2020 Jul;77:227-229. doi: 10.1016/j.jocn.2020.05.018. Epub 2020 May 6.
Coronaviruses are revealed to target the human respiratory system mainly. However, they also have neuro-invasive abilities and might spread from the respiratory system to the central nervous system. Herein, we report four patients with COVID-19 simultaneously diagnosed with acute ischemic stroke. There were four stroke cases with simultaneously diagnosis of Covid-19 till the April 14, 2020 in the city of Sakarya, Turkey. They were aged between 45 and 77 years. All four cases were likely to have contracted the virus in Sakarya. The patients had all commonly reported symptoms of Covid-19. Three patients have elevated D-dimer levels, and two of them had high C-reactive protein (CRP) levels. They were managed symptomatically for both the infection and the stroke. Our findings suggest that ischemic cerebrovascular diseases may simultaneously develop in the course of Covid-19 independently of the critical disease process. Increased inflammation predicted by CRP and D-dimer levels may play a role in the formation of ischemia. In particular, elder patients with prothrombotic risk factors should also be considered for the signs of cerebrovascular events in addition to infectious symptoms.
冠状病毒主要被发现针对人体呼吸系统。然而，它们也具有神经侵袭能力，可能从呼吸系统传播到中枢神经系统。在此，我们报告了 4 例同时诊断为 COVID-19 的急性缺血性脑卒中患者。截至 2020 年 4 月 14 日，土耳其萨卡里亚市共诊断出 4 例同时患有 COVID-19 的脑卒中病例。这 4 名患者的年龄在 45 至 77 岁之间。所有 4 例均可能在萨卡里亚感染了该病毒。患者均有常见的 COVID-19 症状。3 例患者 D-二聚体水平升高，其中 2 例 C 反应蛋白（CRP）水平升高。他们均对感染和脑卒中进行了对症治疗。我们的研究结果表明，在 COVID-19 病程中，缺血性脑血管病可能独立于危急疾病过程而同时发生。CRP 和 D-二聚体水平预示的炎症增加可能在缺血形成中起作用。特别是，具有血栓形成风险因素的老年患者除了感染症状外，还应考虑脑血管事件的迹象。
