Wijeratne Tissa, Sales Carmela A, Crewther Sheila G, Nguyen Vinh, Karimi Leila
Department of Neurology, Australian Institute for Musculoskeletal Science, Western Centre for Health Research & Education, Melbourne Medical School, Sunshine Hospital Western Health, St Albans, AUS.
Department of Psychology and Public Health, La Trobe University, Bundoora, AUS.
Cureus. 2020 Sep 10;12(9):e10366. doi: 10.7759/cureus.10366.
A case of a 75-year-old man with COVID-19, severe neurological symptoms (acute stroke-like symptoms and signs and full recovery after a prolonged hospital stay), and intracranial hypertension is discussed with an in-depth review of his clinical features, biochemistry, haematology, highlighting the relationship between changes in neutrophil-lymphocyte ratio, C-reactive protein level, D-dimer level, and the clinical onset of acute ischemic stroke-like symptoms in the setting of COVID-19 and major neurological manifestations. This is the first such case reported in Australia to date. This case also illustrates the recovery of a patient with COVID-19 complicated with severe neurological symptoms (acute ischemic stroke-like symptoms) during the prolonged intensive care unit stay (at day 26) followed by slow neurorehabilitation and normal recovery from both respiratory and neurological involvement. The onset of acute stroke-like symptoms appears to be closely associated with changes of neutrophil-lymphocyte ratio and in C-reactive protein, and D-dimer levels.
讨论了一例75岁男性新冠肺炎患者，该患者有严重的神经症状（急性中风样症状和体征，住院时间延长后完全康复）及颅内高压，并对其临床特征、生物化学、血液学进行了深入回顾，重点强调了在新冠肺炎背景下中性粒细胞与淋巴细胞比值、C反应蛋白水平、D-二聚体水平的变化与急性缺血性中风样症状临床发作及主要神经表现之间的关系。这是澳大利亚迄今为止报道的首例此类病例。该病例还说明了一名新冠肺炎合并严重神经症状（急性缺血性中风样症状）的患者在重症监护病房长时间住院期间（第26天）的康复情况，随后进行了缓慢的神经康复治疗，呼吸和神经方面的病变均实现了正常康复。急性中风样症状的发作似乎与中性粒细胞与淋巴细胞比值以及C反应蛋白和D-二聚体水平的变化密切相关。
