在需要体外膜肺氧合（ECMO）的重症新型冠状病毒肺炎（COVID-19）感染情况下发生的出血性卒中。
Hemorrhagic stroke in setting of severe COVID-19 infection requiring Extracorporeal Membrane Oxygenation (ECMO).
作者信息
Zahid Muhammad J, Baig Anam, Galvez-Jimenez Nestor, Martinez Nydia
机构信息
PGY-2, Neurology, Cleveland Clinic Florida, Department of Neurology, 2950 Cleveland Clinic Blvd., Weston, FL 33331.
PGY-4, Neurology Cleveland Clinic Florida.
出版信息
J Stroke Cerebrovasc Dis. 2020 Sep;29(9):105016. doi: 10.1016/j.jstrokecerebrovasdis.2020.105016. Epub 2020 Jun 6.
OBJECTIVE
To highlight the increased risk of hemorrhagic stroke secondary to postulated COVID-19 mediated vasculopathy with concomitant ECMO related bleeding complications.
BACKGROUND
COVID-19 has shown to be a systemic illness, not localized to the respiratory tract and lung parenchyma. Stroke is a common neurological complication. In particular, critically ill patients on ECMO are likely at higher risk of developing hemorrhagic stroke.
CASE PRESENTATION
38-year-old man presented with fever, cough, and shortness of breath. Due to severe respiratory failure, he required ECMO support. Subsequently, he was found to have left temporal intraparenchymal hemorrhage. Overall, his clinical course improved, and he was discharged with minimal neurological deficits.
CONCLUSION
Although intracranial hemorrhage is a known complication of ECMO, patients with COVID-19 infection may be at a higher risk of cerebrovascular complications due to vasculopathy.
目的
强调因假定的新型冠状病毒肺炎（COVID-19）介导的血管病变继发出血性卒中的风险增加，以及体外膜肺氧合（ECMO）相关出血并发症。
背景
COVID-19已被证明是一种全身性疾病，并不局限于呼吸道和肺实质。卒中是一种常见的神经并发症。特别是，接受ECMO治疗的重症患者发生出血性卒中的风险可能更高。
病例介绍
一名38岁男性出现发热、咳嗽和呼吸急促。由于严重呼吸衰竭，他需要ECMO支持。随后，他被发现左侧颞叶脑实质内出血。总体而言，他的临床病程有所改善，出院时神经功能缺损最小。
结论
虽然颅内出血是ECMO已知的并发症，但COVID-19感染患者由于血管病变可能有更高的脑血管并发症风险。
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