Tabibkhooei A, Hatam J, Mokhtari M, Abolmaali M
Department of Neurology, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
New Microbes New Infect. 2021 Mar;40:100848. doi: 10.1016/j.nmni.2021.100848. Epub 2021 Feb 12.
Since March 2020, the pandemic of coronavirus disease 2019 (COVID-19) has become a threat to global health. Several kinds of coronavirus-associated disorders, including vascular involvements with neurological symptoms, have been reported worldwide. Here, we describe two individuals with COVID-19 with no history of traumatic brain injury nor of vascular injuries, who developed spontaneous subdural haematoma in a subacute process. Both individuals became lethargic and unresponsive during admission in the intensive care unit. Both have undergone emergent craniotomy with acceptable outcome. The first patient improved significantly and was discharged a week after surgery. However, the second individual had no improvement on her consciousness and died 3 days after surgery. Haemorrhagic events, including subdural haematoma, can happen during COVID-19 infection with several possible mechanisms. Brain imaging and further neurological evaluation must be performed in any individuals with COVID-19 who show signs of alteration in their state of consciousness.
自2020年3月以来，2019冠状病毒病（COVID-19）大流行已成为对全球健康的威胁。全球范围内已报告了几种与冠状病毒相关的疾病，包括伴有神经症状的血管受累情况。在此，我们描述了两名COVID-19患者，他们既没有创伤性脑损伤史，也没有血管损伤史，却在亚急性病程中发生了自发性硬膜下血肿。两名患者在重症监护病房住院期间均变得嗜睡且无反应。两人均接受了急诊开颅手术，结果尚可。第一名患者术后明显好转，术后一周出院。然而，第二名患者意识没有改善，术后3天死亡。包括硬膜下血肿在内的出血性事件可能在COVID-19感染期间发生，有几种可能的机制。对于任何出现意识状态改变迹象的COVID-19患者，都必须进行脑成像和进一步的神经学评估。
