Nakamura Yukihiko, Takashima Chihiro, Nonaka Takahisa, Ohkubo Taku, Kawano Takayuki, Okura Akira, Kondou Daisuke, Sonoda Kazutaka, Hirohata Masaru, Morioka Motohiro
Department of Neurosurgery, Saiseikai Fukuoka General Hospital, Fukuoka, Japan.
Department of Neurology, Saiseikai Fukuoka General Hospital, Fukuoka, Japan.
Surg Neurol Int. 2023 Sep 8;14:324. doi: 10.25259/SNI_517_2023. eCollection 2023.
The coronavirus disease 2019 (COVID-19) pandemic has caused significant structural changes in acute care hospitals. COVID-19-associated stroke has gained attention, with abnormal coagulation and vascular endothelial damage being recognized. While ischemic cases are commonly reported, hemorrhagic cases have also been reported. This report presents a case of ruptured vertebral artery dissection aneurysm associated with COVID-19, resulting in subarachnoid hemorrhage (SAH). The treatment course, challenges in managing cerebral vasospasm, and early recanalization achieved through endovascular therapy are described.
A 67-year-old male patient was brought to our hospital for emergency treatment of impaired consciousness that occurred while recovering from COVID-19. He underwent endovascular internal trapping using coils, and although the rupture did not recur, he required long-term tracheal management, which resulted in a cerebral infarction caused by cerebral vasospasm. In addition, early recanalization was seen, which required retreatment.
This case highlights the challenges in managing COVID-19-associated SAH and emphasizes the need for infection control measures and proper postoperative care. Establishing protocols for detecting and managing cerebral vasospasm is essential.
2019年冠状病毒病（COVID-19）大流行已导致急症医院发生重大结构变化。与COVID-19相关的中风已受到关注，人们认识到其存在凝血异常和血管内皮损伤。虽然缺血性病例较为常见，但出血性病例也有报道。本报告介绍了1例与COVID-19相关的椎动脉夹层动脉瘤破裂导致蛛网膜下腔出血（SAH）的病例。描述了治疗过程、处理脑血管痉挛的挑战以及通过血管内治疗实现的早期再通情况。
一名67岁男性患者因COVID-19康复过程中出现意识障碍被送至我院急诊。他接受了使用弹簧圈的血管内原位栓塞治疗，虽然破裂未复发，但他需要长期气管管理，这导致了由脑血管痉挛引起的脑梗死。此外，出现了早期再通，需要再次治疗。
该病例凸显了管理与COVID-19相关的SAH的挑战，并强调了感染控制措施和适当术后护理的必要性。制定检测和处理脑血管痉挛的方案至关重要。
