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新冠肺炎住院患者中严重且罕见的神经系统并发症

Serious and infrequent neurological complications in hospitalized patients with COVID19.

作者信息

López-Hortúa Maira A, Rodríguez-Hernández Pablo Andrés, Alviarez-Chaustre Kerly, Rivera-Hernández Stefany, Sánchez-Barrero Carlos Andrés, Valderrama-Mendoza Nelson, Miranda-Acosta Yeiris, Torres-Bayona Sergio

机构信息

School of Medicine, Grupo de investigación básica y traslacional GIBAT, Universidad El Bosque, Bogotá, Colombia.

Department of Neurological Surgery and Spine Unit, Los Cobos Medical Center, Bogotá, Colombia.

出版信息

Interdiscip Neurosurg. 2022 Jun;28:101493. doi: 10.1016/j.inat.2022.101493. Epub 2022 Jan 12.

Abstract

BACKGROUND

SARS-CoV-2 virus infection may affect other organs including the nervous system with variable neurological manifestations, even some research has reported that SARS-CoV-2 can be found in the brain parenchyma and / or in the cerebrospinal fluid (CSF). Although these reports of neurological involvement secondary to COVID-19 has increased, the clinical manifestations and the forms of neurological invasion is not fully understood.

OBJECTIVES

In this paper, we report a case series of patients with SARS-CoV-2 infection with involvement of the nervous system and its neurological complications. In addition, a bibliographic review was developed in different databases with the aim of expanding information on neurological complications and the pathophysiological mechanisms of invasion to the nervous system.

CASE REPORT

Case 1, a 79 year old male developed an infarct of the head of the caudate nucleus and thrombosis of the superior longitudinal sinus. Case 2, a 62 year old female developed an intraparenchymal hemorrhage in the left parietal lobe while hospitalized and COVID19 encephalitis was diagnosed. Case 3, a 59 year old healthy male developed a Fisher IV subarachnoid hemorrhage by aneurysmal origin of the right middle cerebral artery and right temporal intraparenchymal hematoma, due to rapid and severe neurological impairment new brain images was performed showing a right cerebellar ischemic stroke leading to compression of the cistern and brainstem.

CONCLUSIONS

In these cases, the surgery goal was relieved symptoms, neurologic functional recovery, and life survival. We considered its diffusion and knowledge as imperative for all practitioners involved in the care of this patient.

摘要

背景

严重急性呼吸综合征冠状病毒2(SARS-CoV-2)病毒感染可能会影响包括神经系统在内的其他器官,表现出多种神经症状。甚至有研究报告称,在脑实质和/或脑脊液(CSF)中可检测到SARS-CoV-2。尽管关于新型冠状病毒肺炎(COVID-19)继发神经受累的报道有所增加,但对其临床表现和神经侵袭形式仍未完全了解。

目的

本文报告了一系列SARS-CoV-2感染累及神经系统及其神经并发症的病例。此外,还在不同数据库中进行了文献综述,以扩展有关神经并发症及神经系统侵袭病理生理机制的信息。

病例报告

病例1,一名79岁男性发生尾状核头部梗死和上矢状窦血栓形成。病例2,一名62岁女性在住院期间发生左顶叶脑实质内出血,被诊断为COVID-19脑炎。病例3,一名59岁健康男性因右侧大脑中动脉动脉瘤破裂导致Ⅳ级费希尔(Fisher)综合征蛛网膜下腔出血及右侧颞叶脑实质内血肿,由于出现快速且严重的神经功能障碍,进行了新的脑部影像检查,显示右侧小脑缺血性卒中,导致脑池和脑干受压。

结论

在这些病例中,手术目标是缓解症状、促进神经功能恢复和挽救生命。我们认为,对于所有参与此类患者护理的医护人员来说,了解其传播情况和相关知识至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2dd7/8752167/7bb46452ae69/gr1_lrg.jpg

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