scholarly journals SARS-COV-2 infection during pregnancy, a risk factor for eclampsia or neurological manifestations of COVID-19? Case report

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Alejandro Garcia Rodriguez ◽  
Sergio Marcos Contreras ◽  
Santiago Manuel Fernandez Manovel ◽  
Jose Miguel Marcos Vidal ◽  
Fernando Diez Buron ◽  
...  
Keyword(s):  
Normal Pregnancy ◽  
Neurological Complications ◽  
Endothelial Damage ◽  
Cortical Blindness ◽  
Normal Brain ◽  
Case Presentation ◽  
Patient Groups ◽  
Clonic Seizures ◽  
Posterior Reversible Leukoencephalopathy ◽  
Endothelium Damage

Abstract Background There are no published cases of tonic-clonic seizures and posterior bilateral blindness during pregnancy and Severe Acute Respiratory Syndrome (SARS) Coronavirus (COV) 2 (SARS-COV-2) infection. We do not just face new and unknown manifestations, but also how different patient groups are affected by SARS-COV-2 infection, such as pregnant women. Coronavirus Disease 2019 (COVID-19), preeclampsia, eclampsia and posterior reversible leukoencephalopathy share endothelium damage and similar pathophysiology. Case presentation A 35-year-old pregnant woman was admitted for tonic-clonic seizures and SARS-COV-2 infection. She had a normal pregnancy control and no other symptoms before tonic-clonic seizures development. After a Caesarean section (C-section) she developed high blood pressure, and we initiated antihypertensive treatment with labetalol, amlodipine and captopril. Few hours later she developed symptoms of cortical blindness that resolved in 72 h with normal brain computed tomography (CT) angiography. Conclusion The authors conclude that SARS COV-2 infection could promote brain endothelial damage and facilitate neurological complications during pregnancy.

scholarly journals SARS-COV-2 infection during pregnancy, a risk factor for eclampsia or neurological manifestations of COVID-19? Case report.

2020 ◽  
Author(s):  
Alejandro Garcia Rodriguez ◽  
Sergio Marcos Contreras ◽  
Santiago Manuel Fernandez Manovel ◽  
Jose Miguel Marcos Vidal ◽  
Fernando Diez Buron ◽  
...  
Keyword(s):  
Antihypertensive Treatment ◽  
Normal Pregnancy ◽  
Neurological Complications ◽  
Endothelial Damage ◽  
Normal Brain ◽  
Case Presentation ◽  
Brain Ct Scan ◽  
Clonic Seizures ◽  
Posterior Reversible Leukoencephalopathy ◽  
Endothelium Damage

Abstract Background: There are no published cases of tonic-clonic seizures and posterior bilateral blindness during pregnancy and SARS-COV-2 infection. We do not just face new and unknown manifestations, but also how different patients groups are affected by SARS-Cov-2 infection, like pregnant women. COVID-19, preeclampsia, eclampsia and posterior reversible leukoencephalopathy share endothelium damage and similar pathophysiology. Case presentation: We present a case of a 35 years old pregnant woman, who comes to our hospital because of tonic-clonic seizures at home and SARS-COV-2 infection. After Caesarean section, we initiate antihypertensive treatment with labetalol, amlodipine and captopril. Few hour after C-section, she develops blindness with total recuperation after 72 hours, normal brain CT scan and normal CT angiography. She had normal pregnancy control and no other symptoms before tonic-clonic seizures development. Conclusion: SARS-COV-2 infection could promote brain endothelial damage and facilitate neurological complications during pregnancy.

scholarly journals Unexplained worsening of parkinsonian symptoms in a patient with advanced Parkinson’s disease as the sole initial presentation of COVID-19 infection: a case report

2021 ◽  
Vol 57 (1) ◽  
Author(s):  
Walaa A. Kamel ◽  
Ismail Ibrahim Ismail ◽  
Mohamed Ibrahim ◽  
Jasem Y. Al-Hashel
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Viral Infections ◽  
Neurological Complications ◽  
Initial Presentation ◽  
Nasopharyngeal Swab ◽  
Initial Manifestation ◽  
Advanced Parkinson’S Disease ◽  
Case Presentation ◽  
Dystonic Posturing

Abstract Background Parkinson’s disease (PD) is a neurodegenerative condition that has been reported following viral infections in rare occasions. Several neurological complications have emerged in association with coronavirus disease 2019 (COVID-19), since its declaration as a pandemic. Herein, we present a novel case of unexplained worsening of PD as the sole initial presentation of COVID-19, in the absence of fever or respiratory symptoms. Case presentation A 56-year-old male with advanced PD presented with severe rigidity, dystonic posturing of both feet, and confusion of 4 days duration. His condition progressed to an akinetic-rigid state and confusion during the following week, and a routine nasopharyngeal swab tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on the 9th day of onset. He developed fever and dyspnea later and was intubated on the 10th day. Conclusion To our knowledge, worsening of PD symptoms as the sole initial manifestation of SARS-CoV-2 infection, in the absence of other cardinal features of COVID-19, has not been reported in the literature. We suggest testing for COVID-19 infection in patients with PD, especially advanced cases, who present with unexplained worsening of symptoms, even in the absence of COVID-19 cardinal features.

Histopathological analysis of incompetent great saphenous veins after mechanochemical ablation treatment – An ex-vivo experiment

Vascular ◽  
2021 ◽  
pp. 170853812110076
Author(s):  
Bo Yang ◽  
Qiang-Qiang Nie ◽  
Xue-Qiang Fan ◽  
Jian-Bin Zhang ◽  
Peng Liu
Keyword(s):  
Ex Vivo ◽  
Endothelial Damage ◽  
Statistical Result ◽  
Histopathological Analysis ◽  
Saphenous Veins ◽  
Mechanochemical Ablation ◽  
Group A ◽  
Endothelium Damage ◽  
Group B ◽  
Group D

Background The endovascular technique of mechanochemical ablation (MOCA) has become popular in treating patients with saphenous reflux. We reported the histopathological findings in human ex-vivo incompetent great saphenous veins following treatment with saline, polidocanol, mechanical ablation and MOCA using ClariVein device. Methods Twenty-four vein GSV specimens were obtained via traditional surgery and treated with four methods: Group A: 0.9% normal saline (NS); Group B: 3% polidocanol; Group C: mechanical ablation + 0.9% NS; Group D: mechanical ablation + 3% polidocanol (MOCA). Hematoxylin and eosin (HE), Masson’s trichrome and immunohistochemical staining were performed on each specimen and integrated optical densities were measured with vWF and a-SMA stains and statistically evaluated. vWF staining was used to assess endothelial damage and a a-SMA staining was used to assess media injury. Results HE and Masson’s trichrome staining of Groups C and D revealed severe damage to the endothelium and media compared to Groups A and B. The statistical result of vWF staining showed the damage of endothelium was significantly increased by Group D compared to Groups A, B and C. The statistical result of a-SMA staining showed the damage of media was significantly increased by Groups C and D compared to Groups A and B. Conclusions The mechanism of MOCA was caused by both endothelium damage and media tearing. The damage of endothelium was significantly increased by MOCA when compared with mechanical ablation alone.

scholarly journals The Downside of Radiosurgery, Possible Complications

2018 ◽  
Vol 25 (3) ◽  
pp. 286-299
Author(s):  
Luiz Claudio Modesto Pereira ◽  
Valeria Patricia De Araujo ◽  
Thiago Henrique de Moraes Modesto
Keyword(s):  
Tumor Imaging ◽  
Neurological Complications ◽  
Normal Brain ◽  
Radiation Delivery ◽  
Cranial Nerve Dysfunction ◽  
Technological Advances ◽  
Treatment Dose ◽  
Barrier Breakdown ◽  
Nerve Dysfunction ◽  
Blood Brain Barrier Breakdown

As a consequence of various last century scientific and technological advances radiotherapy and stereotactic radiosurgery (SRS) have emerged as safe and efficacious techniques for the treatment of various intracranial pathologies. Recent improvements such as in brain and tumor imaging, patient immobilization, 3D planning and radiation delivery allow it to target lesions more accurately and minimize radiation delivered to normal brain, leading to drastic improvements in terms of safety and post-therapy complication. Despite that SRS still implies in moderate to severe side effects in one fifth to one fourth of patients. Fortunately the most common SRS complications, such as edema, blood brain barrier breakdown and MRI abnormalities are self-limited and amenable to treatment. The precise pathophysiological processes of SRS complications are still under research, however multiple factors including treatment dose, modality and planning complexity, target size, shape and location are known to affect treatment results. The most reported potential SRS complications are ischemic stroke, brain or lesion hemorrhage, radiosurgeryinduced neoplasm, radiation necrosis, white matter changes, cranial nerve dysfunction and cognition problems. SRS induced neurological complications may persist only in as much as 5% of patients.

scholarly journals Cyclosporine-Associated Leukoencephalopathy in a Case of Sympathetic Ophthalmitis

2016 ◽  
Vol 7 (1) ◽  
pp. 61-66 ◽  
Author(s):  
Mizuki Tagami ◽  
Atsushi Azumi
Keyword(s):  
Trough Level ◽  
Immunosuppressive Agent ◽  
Cortical Blindness ◽  
High Signal ◽  
Mri Findings ◽  
Case Presentation ◽  
Normal Limits ◽  
Normal Ranges ◽  
Sympathetic Ophthalmitis ◽  
Reversible Encephalopathy

Purpose: Cyclosporine (CsA) is currently widely used as a primary immunosuppressive agent in ocular disease, particularly in severe uveitis. Posterior reversible encephalopathy syndrome (PRES) is a significant complication of CsA therapy. However, there are no reports of the occurrence of PRES in response to the treatment of uveitis in the ophthalmological area. Case Presentation: We report a case with CsA-associated PRES. A 70-year-old woman with sympathetic ophthalmitis was treated with 50 mg/day of CsA for 1 week. However, the trough level in her blood was too low; thus, we increased the dose to 100 mg/day of CsA with prednisolone. She had headaches, hypertension (systolic blood pressure 180-200 mm Hg), loss of consciousness for several hours, and reduced limb movement, and her MRI showed a high signal intensity in both posterior lobes, consistent with PRES. Examination of the cerebrospinal fluid indicated that it was within normal limits. Her CsA trough level in the blood was within normal ranges on the day of the attack. Her symptoms gradually improved over the next several days; however, she presented with cortical blindness, which lasted for several weeks. Finally, she returned to her baseline values from before the attack. Her MRI findings showed that PRES had essentially disappeared. Conclusion: PRES is not directly associated with the dosage of CsA administered; however, in general, it is well known that PRES can affect strongly immunosuppressed cases undergoing organ and bone marrow transplantation. Nevertheless, our CsA dose was only 100 mg (1.8 mg/kg). In this study, we report on the occurrence of PRES after the administration of CsA to treat sympathetic ophthalmia. To our knowledge, PRES can also occur after the administration of a small dose of CsA; thus, ophthalmologists using CsA should carefully observe the systemic conditions of CsA-treated patients.

Vascular endothelial growth factor and its receptor, Flt-1, in the plasma of patients with coronary or peripheral atherosclerosis, or Type II diabetes

2002 ◽  
Vol 102 (2) ◽  
pp. 187-194 ◽  
Author(s):  
Andrew D. BLANN ◽  
Funmi M. BELGORE ◽  
Charles N. McCOLLUM ◽  
Stanley SILVERMAN ◽  
Peck Lin LIP ◽  
...  
Keyword(s):  
Vascular Endothelial Growth Factor ◽  
Growth Factor ◽  
Plasma Levels ◽  
Endothelial Damage ◽  
Vascular Endothelial ◽  
Patients With Diabetes ◽  
Patient Groups ◽  
Artery Disease ◽  
Endothelial Growth Factor ◽  
Age And Sex

Since atherosclerosis is characterized by endothelial damage, re-growth seems likely to be occurring in order to repair or replace injured cells. Angiogenic vascular endothelial growth factor (VEGF), a likely mediator of these events, acts on the endothelium via a specific receptor, Flt-1. We hypothesized that patients with different manifestations of atherosclerosis, and others with diabetes, would have altered plasma levels of VEGF and Flt-1 compared with healthy individuals. Accordingly, 70 patients with peripheral artery disease (PAD), 70 patients with coronary artery disease (CAD), and 70 age- and sex-matched healthy controls were recruited. We also recruited 14 patients with diabetes asymptomatic for atherosclerosis, 14 patients with diabetes and atherosclerosis, and 14 age- and sex-matched controls. VEGF and soluble Flt-1 (sFlt-1) were measured by ELISA. In the main study of PAD and CAD, VEGF was raised in both patient groups (P < 0.05) compared with the controls, but was not different between the patient groups. sFlt-1 was lower in patients with PAD (P < 0.05), but not in those with CAD, compared with the controls. VEGF was raised in the patients with diabetes plus atherosclerosis (P < 0.05), but not in the group with diabetes alone; levels of sFlt-1 were unaltered in both diabetes groups. Our data point to changes in plasma levels of VEGF and its receptor sFlt-1 in diabetes and atherosclerosis that may have relevance for therapy and angiogenesis in these conditions.

scholarly journals "Bonded by one chain, related to one purpose": what is primary in the development of thrombotic complications in COVID-19 — mechanisms of inflammation or endothelium damage?

2021 ◽  
Vol 40 (3) ◽  
pp. 45-49
Author(s):  
Dmitriy V. Cherkashin
Keyword(s):  
Heart Failure ◽  
Structural Changes ◽  
Clinical Importance ◽  
Endothelial Damage ◽  
Spike Protein ◽  
Significant Morbidity ◽  
Profound Impact ◽  
Thrombotic Complications ◽  
Coronavirus Infection ◽  
Endothelium Damage

The ongoing COVID-19 pandemic has caused significant morbidity and mortality worldwide, as well as a profound impact on society. Among the nosologies that increase the risk of a severe course of COVID-19, coronary heart disease, chronic heart failure, cardiomyopathy. The main complications caused by coronavirus infection include thrombotic ones. Spike protein SARS-CoV-2 can interact directly with platelets and fibrin, causing blood hypercoagulation and obstructing blood flow. The presence of the spike protein in circulation leads to structural changes in fibrin, complement 3 and prothrombin, which can contribute to hypercoagulability in COVID-19 positive patients and cause a significant violation of fibrinolysis. Endothelial damage and systemic inflammation, being interrelated triggers of coagulopathy characteristic of COVID-19, trigger a cascade of reactions resulting in thrombotic complications against the background of endothelial dysfunction and hyperinflammation, which may be of clinical importance in the treatment of hypercoagulability in patients with COVID-19 (bibliography: 14 refs).

scholarly journals A case of dyskinesia after levetiracetam administration

BMC Neurology ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Soo Hwan Yim ◽  
Yun Ho Choi ◽  
Kyoung Heo ◽  
Kyoo ho Cho
Keyword(s):  
First Generation ◽  
Dopaminergic System ◽  
Case Reports ◽  
Medical Field ◽  
Unusual Manifestation ◽  
Case Presentation ◽  
Unusual Phenomenon ◽  
History Of ◽  
Clonic Seizures ◽  
Video Eeg

Abstract Background Antiepileptic drug (AED) induced dyskinesia is an unusual manifestation in the medical field. In the previous case reports describing first generation-AED related involuntary movements, the authors suggested that a plausible cause is pharmacokinetic interactions between two or more AEDs. To date, development of dyskinesia after levetiracetam (LEV) has not been reported. Case presentation A 28-year-old woman with a history of brain metastasis from spinal cord glioblastoma presented with several generalized tonic-clonic seizures without restored consciousness. LEV was administered intravenously. Thereafter no more clinical or electroencephalographic seizures were noted on video-EEG monitoring, while chorea movement was observed in her face and bilateral upper limbs. Discussion and conclusions To our knowledge, there is no case report of dyskinesia after administration of LEV. Considering the temporal relationship and absence of ictal video-EEG findings, we suggest that development of choreoathetosis was closely associated with the undesirable effects of LEV. We propose that dopaminergic system dysregulation and genetic susceptibility might underlie this unusual phenomenon after LEV treatment.

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