Iqbal Yousaf, Haddad Peter M, Latoo Javed, Alhatou Mohammed Ibrahim, Alabdulla Majid
Department of Psychiatry, Hamad Medical Corporation, Doha, Qatar.
Department of Neurology, Hamad Medical Corporation, Doha, Qatar.
Oxf Med Case Reports. 2021 Mar 8;2021(3):omab006. doi: 10.1093/omcr/omab006. eCollection 2021 Mar.
Most cases of stroke associated with coronavirus disease 2019 (COVID-19) occur during the course of a characteristic COVID-19 respiratory illness. We report three patients where the presenting feature of COVID-19 was stroke. Two patients had no respiratory symptoms throughout their clinical course. In each case, COVID-19 was confirmed by a reverse transcription polymerase chain reaction (RT-PCR) test and the diagnosis of ischaemic stroke by brain imaging. The patients were relatively young (40, 45 and 50 years). None had a prior history of cerebrovascular events. Stroke risk factors were absent in one, limited to overweight and smoking in another but more prominent in the third patient. Two patients had large vessel occlusion and elevated D-dimer levels. Multiple infarcts were seen in two patients. Clinicians should consider the possibility of COVID-19 in patients presenting with stroke and conversely consider investigating for stroke if a patient with COVID-19, even if mildly ill, develops acute neurological symptoms.
大多数与2019冠状病毒病（COVID-19）相关的中风病例发生在典型的COVID-19呼吸道疾病病程中。我们报告了3例以中风为COVID-19首发症状的患者。2例患者在整个临床病程中均无呼吸道症状。在每例病例中，通过逆转录聚合酶链反应（RT-PCR）检测确诊为COVID-19，并通过脑部成像诊断为缺血性中风。患者相对年轻（40、45和50岁）。均无脑血管事件既往史。1例无中风危险因素，另1例仅限于超重和吸烟，但第3例患者的中风危险因素更为突出。2例患者出现大血管闭塞且D-二聚体水平升高。2例患者可见多发性梗死灶。临床医生应考虑中风患者感染COVID-19的可能性，反之，如果COVID-19患者（即使病情较轻）出现急性神经症状，也应考虑对其进行中风方面的检查。
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