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血管并发症：一例新冠后遗症导致后循环梗死的病例报告

Vascular Consequences: A Case Report on Posterior Circulation Infarction as a Sequela of COVID-19.

作者信息

Philip Anil M, George Lina J, Saha Shubhashis, Sadanandan Sethu

机构信息

Internal Medicine, Kuriakose Chavara Memorial Hospital, Nooranad, IND.

Internal Medicine, John H. Stroger, Jr. Hospital of Cook County, Chicago, USA.

出版信息

Cureus. 2024 Jul 31;16(7):e65837. doi: 10.7759/cureus.65837. eCollection 2024 Jul.

DOI:10.7759/cureus.65837
PMID:39219954
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11363812/
Abstract

This case report presents a posterior circulation infarction in a previously healthy 39-year-old male, three months post-severe COVID-19. He presented with right-sided homonymous hemianopia and elevated inflammatory markers and D-dimer levels. Imaging revealed an acute left occipital infarct. Such post-COVID-19 posterior circulation strokes are rare. This report discusses the pathophysiology, optimal anticoagulation therapy for COVID-19-related thrombotic complications, and early predictor models. This case underscores the need to recognize thromboembolic events as potential late sequelae in severe COVID-19 cases.

摘要

本病例报告介绍了一名39岁既往健康男性，在感染重症COVID-19三个月后发生后循环梗死。他出现右侧同向性偏盲，炎症标志物及D-二聚体水平升高。影像学检查显示急性左枕叶梗死。这种COVID-19后循环卒中很罕见。本报告讨论了其病理生理学、针对COVID-19相关血栓并发症的最佳抗凝治疗以及早期预测模型。该病例强调了在重症COVID-19病例中需认识到血栓栓塞事件作为潜在晚期后遗症的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cd73/11363812/48399b391f54/cureus-0016-00000065837-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cd73/11363812/48399b391f54/cureus-0016-00000065837-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cd73/11363812/48399b391f54/cureus-0016-00000065837-i01.jpg

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本文引用的文献

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Clin Infect Dis. 2024 Jan 25;78(1):70-79. doi: 10.1093/cid/ciad469.
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Antithrombotic Therapy in Arterial Thrombosis and Thromboembolism in COVID-19: An American College of Chest Physicians Expert Panel Report.COVID-19 相关动脉血栓形成和血栓栓塞的抗栓治疗：美国胸科医师学会专家小组报告。
Chest. 2023 Dec;164(6):1531-1550. doi: 10.1016/j.chest.2023.06.032. Epub 2023 Jun 29.
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Recombinant tissue plasminogen activator (rTPA) management for first onset acute ischemic stroke with covid -19 and non-covid -19 patients.
重组组织型纤溶酶原激活剂（rTPA）治疗伴 COVID-19 和不伴 COVID-19 的首发急性缺血性脑卒中患者。
J Stroke Cerebrovasc Dis. 2023 Apr;32(4):107031. doi: 10.1016/j.jstrokecerebrovasdis.2023.107031. Epub 2023 Jan 23.
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Failure of Therapeutic Anticoagulation in COVID-19 Patients With Acute Ischemic Stroke. A Retrospective Multicenter Study.新冠病毒肺炎合并急性缺血性卒中患者治疗性抗凝治疗失败：一项回顾性多中心研究
Front Neurol. 2022 Mar 4;13:834469. doi: 10.3389/fneur.2022.834469. eCollection 2022.
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Anticoagulation in COVID-19.新冠疫情中的抗凝治疗
Lancet. 2022 Jan 1;399(10319):5-7. doi: 10.1016/S0140-6736(21)02503-4. Epub 2021 Dec 15.
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