Department of Neurosurgery, Ramaiah Medical College and Hospital, Bangalore, India.
Department of Radiology, Ramaiah Medical College and Hospital, Bangalore, India.
Acta Neurol Taiwan. 2023 Jun 30;32(2):69-73.
Coronavirus disease of 2019 (COVID-19) is associated with increased risk of stroke and intracranial hemorrhage. This first report of fulminant panvascular arteriovenous thrombosis with subarachnoid hemorrhage (SAH) in a post-COVID-19 infection is attributed to extensive arteriovenous inflammation leading to arterial rupture following vasculitis.
We report a rare case of extensive extra- and intra-cranial cerebral arteriovenous thrombosis following COVID-19 infection, presenting as fatal non-aneurysmal subarachnoid hemorrhage. The clinical course, biochemical and radiological evaluation is discussed. The other possible etiological differentials which were analysed and ruled out during case management are also detailed.
A high degree of suspicion for COVID-19 induced coagulopathy leading to extensive non- aneurysmal, non-hemispheric SAH and malignant intracranial hypertension should be entertained. Our experience and previous reports on non-aneurysmal SAH in such patients show a poor prognosis.
2019 年冠状病毒病（COVID-19）与中风和颅内出血的风险增加有关。这是首例 COVID-19 感染后发生暴发性全血管性动静脉血栓形成伴蛛网膜下腔出血（SAH）的报告，归因于广泛的动静脉炎症导致血管炎后动脉破裂。
我们报告了一例 COVID-19 感染后罕见的广泛颅内和颅外脑动静脉血栓形成，表现为致命性非动脉瘤性蛛网膜下腔出血。讨论了临床经过、生化和影像学评估。在病例管理过程中还详细分析并排除了其他可能的病因差异。
应高度怀疑 COVID-19 引起的凝血功能障碍导致广泛的非动脉瘤性、非半球性 SAH 和恶性颅内高压。我们的经验和以前关于此类患者非动脉瘤性 SAH 的报告显示预后不良。
