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COVID-19 相关的颈内动脉血栓形成。

Internal carotid artery thrombosis in COVID 19.

机构信息

Instituto Hondureño de Seguridad Social IHSS, Tegucigalpa, Honduras.

Honduras Medical Center, Tegucigalpa, Honduras.

出版信息

Colomb Med (Cali). 2020 Sep 30;51(3):e504560. doi: 10.25100/cm.v51i3.4560.

Abstract

CASE DESCRIPTION

37-year-old female with PCR-RT swab for COVID-19 positive, with neurological manifestation as a result of internal carotid artery occlusion.

CLINICAL FINDINGS

Nasal congestion and sneezing of 5 days duration; pulsatile headache in the left hemicranium 3 days prior to admission, with intensity 6/10 according to the visual analogue scale, accompanied by phosphenes, photophobia and diplopia; with subsequent developing right hemiparesis over a 26-hour period.

TREATMENT AND RESULT

She was given medical management with oral antiplatelet agents and anticoagulants (subcutaneous and oral) during his hospitalization, it was not possible to perform thrombolysis and thrombectomy due to the high risk of complications. He was discharged at 14 days, without functional limitation, symmetrical strength in upper and lower limbs, bilateral visual acuity 20/20, denying headache.

CLINICAL RELEVANCE

The case presented here describes a pattern in how data supporting an association between COVID-19 and stroke in young populations with or without typical vascular risk factors, sometimes with only mild respiratory symptoms, is increasing. Prospective studies are required to further evaluate this association, as well as anticoagulation studies to prevent these potentially life-threatening events.

摘要

病例描述

37 岁女性,聚合酶链反应-逆转录酶检测新冠病毒阳性,其神经系统表现为颈内动脉闭塞。

临床发现

5 天前出现鼻塞和打喷嚏;入院前 3 天出现左侧颅痛,视觉模拟评分 6/10,伴有幻视、畏光和复视;随后在 26 小时内出现右侧偏瘫。

治疗及结果

住院期间给予口服抗血小板药物和抗凝药物(皮下和口服)治疗,因并发症风险高,未能进行溶栓和血栓切除术。14 天后出院,无功能受限,上下肢肌力对称,双侧视力 20/20,否认头痛。

临床相关性

本例描述了一种模式,即越来越多的数据支持新冠病毒与年轻人群中风之间的关联,无论其是否具有典型的血管危险因素,有时仅表现为轻微的呼吸道症状。需要进行前瞻性研究来进一步评估这种关联,以及抗凝研究来预防这些潜在的危及生命的事件。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0460/7744109/d5ddfea49ceb/1657-9534-cm-51-03-e504560-gf1.jpg

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