scholarly journals Acute cerebral circulatory disorders and coronavirus disease

2020 ◽  
pp. 18-25
Author(s):  
N. V. Pizova ◽  
N. A. Pizov ◽  
O. A. Skachkova ◽  
M. A. Sokolov ◽  
I. A. Izmaylov ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Sinus Thrombosis ◽  
Clinical Signs ◽  
Cerebral Venous Sinus Thrombosis ◽  
Altered Level ◽  
Wide Range ◽  
Inflammatory State ◽  
Coronavirus Infection ◽  
Systemic Symptoms

The new COVID-19 coronavirus infection caused by SARS-CoV-2 is a global health threat. Neurological disorders detected in patients with coronavirus infection have a wide range of clinical signs: headache, dizziness, altered level of consciousness, acute ischemic stroke, intracerebral hemorrhage, cerebral venous sinus thrombosis. Evidence suggests that patients with more severe systemic symptoms were more likely to experience neurological symptoms. The main risk factors for the development of ischemic stroke in patients with coronavirus infection are considered. It was shown that COVID-19 more often occurred in people with vascular risk factors, among which the mortality rate was higher. Various possible and not mutually exclusive mechanisms which may play a role in the development of ischemic stroke in patients with COVID-19 are described in detail, including hyper-inflammatory state («cytokine storm»), «COVID-19-associated coagulopathy», and disseminated intravascular coagulation syndrome. Stroke risk factors associated with the critical condition in these patients are presented. Stroke, the leading cause of death and disability worldwide, requires immediate treatment and decision-making as well as 24/7 availability for specialized vascular centers. The results of observation of patients with acute cerebral circulation disorder in specialized vascular centers 2 months before and 15 days after quarantine due to COVID-19 are presented. The tactics of managing patients with ischemic stroke under conditions of coronavirus infection is considered.

scholarly journals Clinical associations, biological risk factors and outcomes of cerebral venous sinus thrombosis

2016 ◽  
Vol 44 (6) ◽  
pp. 1454-1461 ◽  
Author(s):  
Hafize Nalan Gunes ◽  
Burcu Gokce Cokal ◽  
Selda Keskin Guler ◽  
Tahir Kurtulus Yoldas ◽  
Umit Yavuz Malkan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Sinus Thrombosis ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus ◽  
Common Symptom ◽  
Venous Sinus Thrombosis ◽  
Hospitalization Period ◽  
Wide Range ◽  
Significant Difference ◽  
Clinical Associations

Objective Cerebral venous sinus thrombosis (CVST) is a rare cerebrovascular disease affecting young adults. The majority of the patients are female. The aim of this study is to assess the clinical associations, risk factors and outcomes of the patients with CVST. Methods The data of 75 patients with CVST admitted to our hospital between 2006 and 2016 were reviewed. Demographic and clinical features and the thrombophilic risk factors of the patients were recorded. The localizations of the thrombi were determined and modified Rankin score at the time of onset and discharge were calculated. Results The majority of our patients (78.7%) were female. Median age was 35 years (16–76). The most common symptom was headache (86.7%). In 82.6% of our patients, inherited or acquired risk factors for thrombosis were detected. Transverse sinus was the most common site of thrombosis followed by sigmoid and superior sagittal sinuses. Two thirds of the patients had involvement of multiple sinuses. The patients with the involvement of sagittal sinus had better disability at the time of admittance ( p = 0.013) while the number of involved sinuses was correlated worse disability ( p = 0.015). The neurologic states in the majority of the patients were improved by the end of the hospitalization period ( p = 0.001). There was no significant difference in disability score at discharge between men and women ( p = 0.080). No patient with CVST died in the hospitalization period. Conclusions This study is one of the largest cohort studies on CVST in our region. The results of the study disclosed that CVST had wide range of clinical manifestations and non-specific symptoms at the beginning. For that reason, in especially high risk groups for thrombosis, the diagnosis of CVST should be kept in mind.

scholarly journals Cerebral Venous Sinus Thrombosis in a Child with Idiopathic Nephrotic Syndrome: a case report

2018 ◽  
Vol 40 (4) ◽  
pp. 418-422
Author(s):  
Ana Isabel Rodrigues Silva ◽  
João Tavares ◽  
Ana Sofia Vaz ◽  
Nádia Brito ◽  
Mónica Vasconcelos ◽  
...  
Keyword(s):  
Risk Factors ◽  
Nephrotic Syndrome ◽  
Idiopathic Nephrotic Syndrome ◽  
Sinus Thrombosis ◽  
Clinical Signs ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus ◽  
First Episode ◽  
Venous Sinus Thrombosis ◽  
Acquired Thrombophilia

ABSTRACT Complications are rare in pediatric cases of idiopathic nephrotic syndrome (NS). Thromboembolism ranks among the most uncommon and difficult complications to diagnose, particularly in the first episode of NS, since clinical signs might be unspecific. This report describes the case of a 5-year-old girl with NS for the first time presenting with severe hypoalbuminemia (< 2g/dL). The patient responded poorly to therapy with corticosteroids. On day 8 of hospitalization she started having headaches and vomiting; she did not present hemodynamic alterations, fever or exanthems, and her neurological parameters were normal. The patient was suspected for intracranial hypertension, and computed tomography scans revealed she had cerebral venous sinus thrombosis (CVST). She was started on anticoagulants and showed clinical signs of improvement. The patient had no evident prothrombotic risk factors. She had three other episodes since she was diagnosed, one in which her plasma antithrombin level was low. Although antithrombin levels were normal in her first episode, she was tested after the resolution of proteinuria. The low levels of antithrombin seen in the first recurrence might have mirrored the initial drop in plasma antithrombin levels, an idea supported by the severe hypoalbuminemia she had when diagnosed. This severe manifestation of acquired thrombophilia might be in the origin of CVST. This report presents a rare case of thromboembolic complication in a pediatric patient with NS. The patient progressed well since she was started on anticoagulants. Although she did not present any evident risk factors at first, the development of her case indicated that severe acquired thrombophilia might have worked as the pathophysiological mechanism leading to CVST.

COGNITIVE IMPAIRMENT IN PATIENTS WITH CORONAVIRUS INFECTION

2021 ◽  
Vol 2 (1) ◽  
pp. 5-8
Author(s):  
Gulnoza Urinova ◽  
◽  
Nargiza Nasirtdinova ◽  
Janna Nazarova
Keyword(s):  
Cognitive Impairment ◽  
Neurological Disorders ◽  
Sinus Thrombosis ◽  
The Novel ◽  
Altered Level ◽  
Wide Range ◽  
Level Of Consciousness ◽  
Coronavirus Infection ◽  
Novel Coronavirus ◽  
The Brain

Thisarticle discusses cognitive impairment in patients with coronavirus infection and explains that observations have been made on this topic. The novel coronavirus infection COVID-19 caused by the SARS-CoV-2 coronavirus poses a global health threat. Neurological disordersfound in patients with coronavirus infection have a wide range of clinical neurological signs: headache, dizziness, altered level of consciousness, acute cerebrovascular accident (ACVE), venous sinus thrombosis the brain [12].Keywords:coronavirus infection, cognitive impairment, neurological disorders, headache, dizziness, muscle weakness, encephalopathy, encephalitis

scholarly journals Perinatal ischemic stroke: a five-year retrospective study in a level-III maternity

2015 ◽  
Vol 13 (1) ◽  
pp. 65-71 ◽  
Author(s):  
Virgínia Machado ◽  
Sónia Pimentel ◽  
Filomena Pinto ◽  
José Nona
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Sinus Thrombosis ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus ◽  
Cerebral Stroke ◽  
Left Middle Cerebral Artery ◽  
Arterial Ischemic Stroke ◽  
Venous Sinus Thrombosis ◽  
Neonatal Stroke

Objective To study the incidence, clinical presentation, risk factors, imaging diagnosis, and clinical outcome of perinatal stroke. Methods Data was retrospectively collected from full-term newborns admitted to the neonatal unit of a level III maternity in Lisbon with cerebral stroke, from January 2007 to December 2011. Results There were 11 cases of stroke: nine were arterial ischemic stroke and two were cerebral venous sinus thrombosis. We estimated an incidence of arterial ischemic stroke of 1.6/5,000 births and of cerebral venous sinus thrombosis of 7.2/100,000 births. There were two cases of recurrent stroke. Eight patients presented with symptoms while the remaining three were asymptomatic and incidentally diagnosed. The most frequently registered symptoms (8/11) were seizures; in that, generalized clonic (3/8) and focal clonic (5/8). Strokes were more commonly left-sided (9/11), and the most affected artery was the left middle cerebral artery (8/11). Transfontanelle ultrasound was positive in most of the patients (10/11), and stroke was confirmed by cerebral magnetic resonance in all patients. Electroencephalographic recordings were carried out in five patients and were abnormal in three (focal abnormalities n=2, burst-suppression pattern n=1). Eight patients had previously identified risk factors for neonatal stroke which included obstetric and neonatal causes. Ten patients were followed up at outpatients setting; four patients developed motor deficits and one presented with epilepsy. Conclusions Although a modest and heterogeneous sample, this study emphasizes the need for a high level of suspicion when it comes to neonatal stroke, primarily in the presence of risk factors. The prevalence of neurological sequelae in our series supports the need of long-term follow-up and early intervention strategies.

Management of Idiopathic Intracranial Hypertension during the COVID19 Pandemic

2020 ◽  
Vol 15 ◽  
Author(s):  
Ayman G. Elnahry ◽  
Gehad A. Elnahry
Keyword(s):  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Sinus Thrombosis ◽  
Cerebral Venous Sinus Thrombosis ◽  
Fundus Photography ◽  
Young Females ◽  
Optic Nerve Sheath Fenestration ◽  
Threatening Condition ◽  
Coronavirus Infection

Background: In the current coronavirus disease 2019 (COVID-19) pandemic, health systems are struggling to prioritize care for affected patients, however, physicians globally are also attempting to maintain care for other lessthreatening medical conditions that may lead to permanent disabilities if untreated. Idiopathic intracranial hypertension (IIH) is a relatively common condition affecting young females that could lead to permanent blindness if not properly treated. In this article, we provide some insight and recommendations regarding the management of IIH during the pandemic. Methods: The diagnosis, follow-up, and treatment methods of IIH during the COVID-19 pandemic period are reviewed. COVID-19 as a mimic of IIH is also discussed. Results: Diagnosis and follow-up of papilledema due to IIH during the COVID-19 pandemic can be facilitated by nonmydriatic fundus photography and optical coherence tomography. COVID-19 may mimic IIH by presenting as cerebral venous sinus thrombosis, papillophlebitis, or meningoencephalitis, so a high index of suspicious is required in these cases. When surgical treatment is indicated, optic nerve sheath fenestration may be the primary procedure of choice during the pandemic period. Conclusion: IIH is a serious vision threatening condition that could lead to permanent blindness and disability at a relatively young age if left untreated. It could be the first presentation of a COVID-19 infection. Certain precautions during the diagnosis and management of this condition could be taken that may allow appropriate care to be delivered to these patients while minimizing the risk of coronavirus infection.

scholarly journals DIAGNOSIS OF VENOUS ISCHEMIC STROKE. PART II (ALGORITHMS AND SEMIOLOGY OF DIAGNOSTIC RADIOLOGY. LIMITATIONS IN CLINICAL PRACTICE). A REVIEW

2019 ◽  
Vol 8 (3) ◽  
pp. 104-115
Author(s):  
S. E. Semenov ◽  
E. A. Yurkevich ◽  
I. V. Moldavskaia ◽  
M. G. Shatokhina ◽  
A. S. Semenov
Keyword(s):  
Ischemic Stroke ◽  
Transcranial Doppler ◽  
Sinus Thrombosis ◽  
Pathological Condition ◽  
Diagnostic Algorithm ◽  
Diagnostic Procedures ◽  
Cerebral Venous Sinus Thrombosis ◽  
Standards Of Care ◽  
Unstable Process ◽  
Venous Stroke

Venous stroke in cerebral venous sinus thrombosis is a rare pathological condition with uncertain diagnostic algorithm to ensure prompt treatment by neurologists and radiologists. All the methods are not obligatory in the workup of acute stroke, except computed tomography (CT) and transcranial Doppler. Researchers and clinicians are commonly guided by their own experiences. Therefore, the diagnosis of venous stroke is an unstable process resulting in its underestimation in the general stroke population. The optimal use of neuroimaging methods within the existing standards of care for patients with stroke, determination of the necessary and sufficient set of diagnostic procedures is an organizational and methodical problem. In addition, there is no complete description of venous ischemic stroke patterns in the medical literature. The article reviews existing evidence-based data on the diagnostic algorithms for venous stroke and discusses the probability of detecting radiologic symptoms based on the diagnostic accuracy and effectiveness of such methods as conventional CT and magnetic resonance imaging (MRI), CT and MR angiography, CT and MR perfusion, transcranial Doppler (TCD) and ultrasound of the brachiocephalic arteries stated in the national and international guidelines, as well as our own experience. Limitations of their use and options to overcome major drawbacks including the introduction of teleradiology are considered.

scholarly journals Cerebral venous sinus thrombosis associated with severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) infection

2021 ◽  
pp. 104-104
Author(s):  
Dragan Nikolic ◽  
Marijana Basta-Nikolic ◽  
Vladimir Manojlovic ◽  
Zeljko Zivanovic ◽  
Sanja Vickovic ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mortality Rate ◽  
Severe Acute Respiratory Syndrome ◽  
High Mortality ◽  
Clinical Presentation ◽  
Sinus Thrombosis ◽  
Cerebral Venous Sinus Thrombosis ◽  
Neurological Symptoms ◽  
Venous Sinus ◽  
Venous Sinus Thrombosis

Introduction/Objective. Coagulopathy induced by severe acute respiratory syndrome coronavirus 2 infection (SARS-CoV-2) can be an underlying cause of cerebral venous sinus thrombosis (CVST), a less common type of stroke with a variable clinical presentation and high mortality rate. Objective: to present a series of CVST cases associated with SARS-CoV-2 infection. Methods. This retrospective study evaluated clinical, laboratory and radiological presentation, risk factors, barriers to diagnosis, treatment and outcome of patients with SARS-CoV-2 infection induced CVST. Results. The study comprised 6 patients diagnosed with COVID-19 induced CVST during the 18 months period. Majority (66.7%) had no significant risk factors for developing CVST. Median time from initial COVID-19 diagnosis to onset of neurologic deficit was 7 days (interquartile range 0.5-7 days). Clinical presentation comprised non specific neurological symptoms: headache (83.3%) and decreased consciousness (33.3%), together with elevated levels of D-dimer and inflammatory biomarkers. The transverse (n = 4 or 66.7%), superior sagittal sinuses (n = 3 or 50%) and sigmoid sinus (n = 2 or 33.3%) were most commonly affected. Five patients (83.3%) had minimal to no symptoms at discharge (mRS ? 2). In-hospital mortality in our current series was relatively high (16.7%). Conclusion. The high mortality rate of SARS-CoV-2-associated CVST urges clinicians to suspect CVST in patients with a history of COVID-19 infection presenting with non-specific neurological symptoms in order to provide proper treatment and prevent complications.

scholarly journals Direct thrombolysis for cerebral venous sinus thrombosis

2009 ◽  
Vol 27 (5) ◽  
pp. E7 ◽  
Author(s):  
Maryam Rahman ◽  
Gregory J. Velat ◽  
Brian L. Hoh ◽  
J Mocco
Keyword(s):  
Endovascular Treatment ◽  
Sinus Thrombosis ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus ◽  
First Line ◽  
Venous Sinus Thrombosis ◽  
Cerebral Herniation ◽  
Wide Range ◽  
Vessel Dissection ◽  
Mild Headache

Cerebral venous sinus thrombosis (CVST) is an increasingly diagnosed disease with a wide range of symptoms, ranging from a mild headache to cerebral herniation. A potentially devastating syndrome, CVST has been associated with a mortality rate of 6–10%. In prospective studies, the overall rate of death and dependency from CVST ranges from 8.8 to 44.4%. Systemic anticoagulation remains the first-line treatment. However, a percentage of patients deteriorate despite medical therapy. These cases have resulted in the development of thrombolysis or endovascular treatment for CVST. Initial reports of the use of endovascular treatment of CVST have been promising. However, enthusiasm for the use of endovascular thrombolysis and thrombectomy should be tempered by an understanding of possible risks such as intracerebral hemorrhage and/or vessel dissection. The authors review the literature regarding endovascular treatment of CVST with a description of the chemical and mechanical thrombolytic techniques.

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