Motoie Ryota, Akai Masaya, Kitahara Takahiro, Imamura Hisaji, Tanabe Takeshi, Sarazawa Katsuhiko, Takano Seiichiro, Toda Hiroki, Komatsu Kazuto
Department of Neurosurgery, Japanese Red Cross Fukui Hospital, Japan.
Department of Respiratory Medicine, Japanese Red Cross Fukui Hospital, Japan.
Intern Med. 2020 Oct 15;59(20):2597-2600. doi: 10.2169/internalmedicine.5697-20. Epub 2020 Sep 5.
The relationship between coronavirus disease 2019 (COVID-19) and intracerebral hemorrhage remains unclear. We herein report a case of severe COVID-19 pneumonia complicated by multiple simultaneous intracerebral hemorrhages (MSICH). The patient died eight days after the episode of MSICH. No apparent coagulopathy was observed; however, extracorporeal membrane oxygenation and anticoagulation might have caused the occurrence of MSICH. Laboratory findings showed hypercoagulability, suggesting that thrombotic etiologies, such as sinus thrombosis or cerebral infarction, might also have caused MSICH. MSICH can occur as a fatal complication of COVID-19, and this should be considered when providing treatment.
2019冠状病毒病（COVID-19）与脑出血之间的关系仍不明确。我们在此报告一例严重COVID-19肺炎并发多处同时性脑出血（MSICH）的病例。该患者在发生MSICH后八天死亡。未观察到明显的凝血病；然而，体外膜肺氧合和抗凝可能导致了MSICH的发生。实验室检查结果显示血液高凝状态，提示血栓形成病因，如静脉窦血栓形成或脑梗死，也可能导致了MSICH。MSICH可作为COVID-19的致命并发症出现，在提供治疗时应予以考虑。
