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[一例患有血液循环障碍性脑病并伴有精神分裂症的患者在感染新型冠状病毒后发生缺血性中风和脑水肿的病例]

[The case of the development of ischemic stroke and cerebral edema after SARS-COV-2 infection in a patient with discirculatory encephalopathy and concomitant schizophrenia].

作者信息

Vorobeva O V, Romanova L P

机构信息

Ulyanov Chuvash State University, Cheboksary, Russia.

出版信息

Zh Nevrol Psikhiatr Im S S Korsakova. 2022;122(8. Vyp. 2):26-31. doi: 10.17116/jnevro202212208226.

DOI:10.17116/jnevro202212208226
PMID:36036140
Abstract

The article presents a case of ischemic stroke after SARS-CoV-2 infection in a patient with dyscirculatory encephalopathy and schizophrenia. Patient 44 years old, was hospitalized due to a confirmed diagnosis of a new coronavirus infection (COVID-19) and diagnosed bilateral pneumonia with a damage to 65% of the lung parenchyma. The patient has a history of dyscirculatory encephalopathy and paranoid schizophrenia, a continuous type of course. A fatal outcome occurs on the 2 day of inpatient treatment. A brain autopsy revealed pericellular and perivascular edema, looseness of neuroglia with necrobiotic changes in the brain substance. Neuronal damage, small-focal gliosis, basophilic balls, destructive-productive vasculitis, ischemic small-focus necrosis were revealed. In the lungs, areas of atelectasis, disatelectasis, hyaline membranes, and edematous fluid were found. Epithelium of the convoluted tubules showed dystrophic and necrotic changes. The cause of death of the patient was a new coronavirus infection COVID-19, which caused bilateral viral pneumonia, complicated by the development of acute respiratory failure and COVID-associated ischemic cerebral infarction complicated by neuromorphological changes in the brain.

摘要

本文介绍了一例患有血液循环障碍性脑病和精神分裂症的患者在感染SARS-CoV-2后发生缺血性中风的病例。患者44岁,因确诊新型冠状病毒感染(COVID-19)住院,诊断为双侧肺炎,肺实质损伤达65%。该患者有血液循环障碍性脑病和偏执型精神分裂症病史,病程呈持续型。在住院治疗的第2天出现了致命结局。脑部尸检显示细胞周围和血管周围水肿、神经胶质疏松伴脑实质坏死性改变。发现了神经元损伤、小灶性胶质增生、嗜碱性小球、破坏性增殖性血管炎、缺血性小灶坏死。在肺部,发现了肺不张、肺膨胀不全、透明膜和水肿液区域。曲管上皮显示营养不良和坏死性改变。患者的死亡原因是新型冠状病毒感染COVID-19,其导致双侧病毒性肺炎,并发急性呼吸衰竭,以及COVID相关的缺血性脑梗死,并伴有脑部神经形态学改变。

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