scholarly journals Cerebral and spinal neurological complications in patients with COVID-19: authors’ clinical experience and literature review

2021 ◽  
Vol 36 (2) ◽  
pp. 50-59
Author(s):  
A.V. Paenok ◽  
A.M. Netliukh ◽  
O.Ya. Kobyletskyi ◽  
N.V. Matolinets ◽  
R.-M. M. Yunko ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Retrospective Cohort ◽  
High Probability ◽  
Neurological Complications ◽  
Prospective Analysis ◽  
Minimally Invasive Neurosurgery ◽  
Inflammatory Lesions ◽  
Coronavirus Infection ◽  
Significant Spread ◽  
Clinical Emergency

Objective ‒ to highlight the high probability and features of neurological complications in patients with COVID-19 pneumonia.Materials and methods. A retrospective cohort study was done of 57 patients with COVID-19 pneumonia who were treated at the COVID-location of the Department of Vascular and Minimally Invasive Neurosurgery and Neurology of the Clinical Emergency Hospital of Lviv in the period from June 29 to September 28, 2020 (91 day).Results. Out of the 57 patients 14 (24.6 %) were selected by prospective analysis that had a clear association between COVID-19 pneumonia and neurological complications. Neurological complications of COVID-19 were manifested as ischemic stroke in 57.1 % of patients, encephalopathy with convulsions and without seizures ‒ in 35.7 %, polyneuropathy with tetraparesis, secondary purulent-inflammatory lesions of the spine ‒ in 7.2 %. Neurological complications occurred on average (20. 4 ± 6.1) days after the onset of the disease.Conclusions. Lesions of the spine and structures in the spinal canal after coronavirus infection had a significant spread along the axis of the spine and severe course. The largest (57.1 %) was the proportion of ischemic stroke in the structure of neurological complications of COVID-19, which indicated the severity of the coronavirus infection and its aggressive effect on the nervous system. The effectiveness of treatment of COVID-19 neurological complications depends on the urgency of hospitalization of patients, as evidenced by the correlation between favorable treatment outcomes and the time from disease onst to admission to either therapeutic (r = + 0.37) or neurological department (r = +0.32).

Abstract W MP24: Modified Tibi (Thrombolysis in Brain Ischemia) Grading System for Assessment of Abnormal Residual Flow at Site of Intracranial Occlusion in Acute Ischemic Stroke

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Aftab Ahmad ◽  
Vijay K Sharma ◽  
Ghazala Basir ◽  
Khurshid Khan ◽  
Andrei V Alexandrov ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Functional Outcome ◽  
Brain Ischemia ◽  
High Probability ◽  
Arterial Occlusion ◽  
P Value ◽  
Grading System ◽  
Mean Flow ◽  
Diastolic Flow

Background and purpose: The intracranial blood flow at the site of arterial occlusion in acute ischemic stroke can be measured with Transracial Doppler (TCD) using the Thrombolysis in Brain Ischemia (TIBI) grading system. The TIBI ranges from 0 to 5, where 0 no flow and 5 normal flow. Our study’s aim is to modify the TIBI grading system in order to make it simple to implement in an acute stroke setting. METHODS: We classified Modified TIBI grading as: Grade 0- no flow, Grade 1- Bad flow: there is systolic flow but no diastolic flow or systolic flow with delayed acceleration and diastolic flow, Grade 2-Good flow: normal upstroke systolic flow and diastolic flow with decreased mean flow velocity compared to contralateral vessel by 30 %. We used the clotbust database to evaluate the modified TIBI scoring system. Poor long-term outcome was defined as modified rankin scale (MRS) score > 2. RESULTS: Total of 369 patients with acute ischemic stroke and intracranial arterial occlusion received IV r TPA. Median age was 71 years (IQ range: 58.7-79), Sex: women: 170(46.1%). Median NIHSS was 16 (IQ range: 12.7-2), 17/98 (17.3%) patients with modified TIBI 0, 73/205(35.6%) with modified TIBI 1 and 31/66( 47%) with modified TIBI 2 had achieved complete recanalization ( p value=0001). The multiple logistic regression model revealed Baseline higher NIHSS, systolic BP, glucose and modified TIBI grade 0 were independent negative predictor of complete recanalization. Patients with modified TIBI 3 had high probability of complete recanalization compared to TIBI 0(OR 3.14, CI 95%: 1.4-6.8, P=0.004).Poor outcome at 3 months (MRS>2) was found in 46/75(61.3%) patients with modified TIBI 0, 94/170(55.3%) with modified TIBI 1 and 19/38(33.3%) with modified TIBI 2(P value <0.004). On logistic model age, baseline NIHSS, glucose and TIBI 0 were independent negative predictors of good outcome.Although statistically insignificant but patients with modified TIBI 3 had a trend towards high probability of good functional outcome (OR: 1.73, CI 95%:0.73-4.12, p=0.20). CONCLUSION: Modified TIBI grading system is simplified version of TIBI grading and is easy to understand and apply clinically. It also predicts reliably the recanalization and functional outcome.

NEUROLOGICAL COMPLICATIONS AFTER CORONAVIRUS INFECTION

2021 ◽  
Vol 20 (2) ◽  
pp. 59-64
Author(s):  
V.V. Simonenko ◽  
T.N. Vakal ◽  
D.S. Mikhalik ◽  
G.V. Zhukov ◽  
L.I. Nikolaenkova
Keyword(s):  
Neurological Complications ◽  
Coronavirus Infection

scholarly journals Continuous Blood Purification on Influenza-associated Neurological Disease in Children: A Retrospective Cohort Study

2021 ◽  
Author(s):  
Jingwen Ni ◽  
Kenan Fang ◽  
Zhe Zhao ◽  
Zhiyuan Wang ◽  
Qian Huang ◽  
...  
Keyword(s):  
Cohort Study ◽  
Intensive Care ◽  
Retrospective Cohort Study ◽  
Neurological Disease ◽  
Retrospective Cohort ◽  
Neurological Complications ◽  
Inflammatory Factors ◽  
Continuous Variables ◽  
Exact Test ◽  
Significant Difference

Abstract Background: Due to lack of proven therapies，we evaluated the effect of CBP on Influenza-Associated Neurological Disease in children.Methods: A single-center, retrospective, cohort study was conducted in Luoyang, Henan province China from January 2018 to January 2020. The children with Influenza-associated neurological disease (<18 years old) were enrolled into this study. The children with CBP indications and the parents’ consent received CBP, and the others were treated with maximal intensive care due to failure of parents consent. The outcomes were compared between CBP group and non-CBP group.Categorical variables were presented as percentage and compared by Chi-square test or Fisher’s exact test. Continuous variables were expressed as median (interquartile ranges) and compared with non-parametric independent sample test. Statistical analyses were finished by SPSS (version 26.0) and p < 0.05 (2 tailed) was considered statistically significant.Results: 30 influenza children with Influenza-associated neurological disease were enrolled in this study. 18 received CBP and other 12 were treated with maximal intensive care. There were no differences between CBP and non-CBP children in age, sex, body weight, type of influenza virus, neurological complications, Glasgow score, PIM-2 score and PCIS at admission (p > 0.05). The inflammatory factors (CRP, PCT and IL-6) of 30 cases were tested at admission and after 3 days of admission. In CBP group, the level of IL-6 decreased significantly at 3-day of admission (p = 0.003), the level of CRP and PCT also decreased, but there was no significant difference (p > 0.05). In the non-CBP group, there were no significant difference on level of CRP, PCT and IL-6 between at admission and 3-day of admission (p > 0.05). The 28-day mortality in the CBP group was significantly lower compared to non-CBP group (11.11% vs 50%, p = 0.034).Conclusions: CBP could Reduce inflammatory factors and may reduce 28-day mortality and improve neurologic function of influenza children.Trial registration: http://www.chictr.org.cn/index.aspx (ChiCTR2000031754).

scholarly journals Pregnancy and Zika virus

2020 ◽  
Vol 14 (2) ◽  
pp. 229-238
Author(s):  
T. V. Startseva ◽  
N. N. Kanshina ◽  
M. V. Tretyakova ◽  
V. O. Bitsadze ◽  
J. Kh. Khizroeva ◽  
...  
Keyword(s):  
Nonhuman Primate ◽  
Zika Virus ◽  
Congenital Malformations ◽  
Asymptomatic Carrier ◽  
Clinical Signs ◽  
Neurological Complications ◽  
Zikv Infection ◽  
Coronavirus Infection ◽  
Novel Coronavirus ◽  
Urban Cycle

Zika virus (ZIKV) is an arthropod-borne virus (arbovirus) in the genus Flavivirus and the Flaviviridae family. In 1947 and 1948 ZIKV was first isolated from a nonhuman primate as well as from mosquitoes in Africa, respectively. For half a century, ZIKV infections in human were sporadic prior to 2015–2016 pandemic spreading. Transmission of ZIKV from mother to fetus can occur in any trimester of pregnancy, even if mother was an asymptomatic carrier. The clinical signs of ZIKV infection are nonspecific and can be misdiagnosed as some other infectious diseases, especially those caused by arboviruses such as Dengue and Chikungunya. ZIKV infection was solely associated with mild illness prior to the large French Polynesian and Brazil outbreaks, when severe neurological complications, Guillain–Barre syndrome and dramatically increased rate of severe congenital malformations (including microcephaly) were reported. The adaptation of ZIKV to an urban cycle in endemic areas suggests that the incidence of ZIKV infections may be underestimated. The pandemic of novel coronavirus infection (COVID-19) demonstrates that lessons from ZIKV pandemic propagation has not been learned properly.

scholarly journals An acute ischemic stroke after multiple bee stings in an elderly patient

2013 ◽  
Vol 4 (2) ◽  
pp. 55-58
Author(s):  
Niranjan Mambally Rachaiah ◽  
Rajashekar Hirisave Kalegowda ◽  
Rashmi Bhadravathy Krishnaswamy
Keyword(s):  
Computed Tomography ◽  
Elderly Patient ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Neurological Complications ◽  
Neurologic Deficit ◽  
Allergic Reactions ◽  
Medical Sciences ◽  
Wasp Stings ◽  
Focal Neurologic Deficit

Although bee stings can cause local and systemic allergic reactions, neurological complications are rare. There are few reports of stroke following bee or wasp stings. We report a 70-year-old healthy man developed a focal neurologic deficit 5 hours after multiple bee stings, which was confirmed to be an acute ischemic stroke on computed tomography (CT) scan.DOI: http://dx.doi.org/10.3126/ajms.v4i2.7892Asian Journal of Medical Sciences 4(2013) 55-58

scholarly journals Estimation of expected years of life lost for patients with ischemic stroke and intracerebral hemorrhage

2019 ◽  
Vol 33 (5) ◽  
pp. 408-415
Author(s):  
Nipaporn Butsing ◽  
Mathuros Tipayamongkholgul ◽  
Disya Ratanakorn
Keyword(s):  
Ischemic Stroke ◽  
Intracerebral Hemorrhage ◽  
Retrospective Cohort ◽  
Design Methodology ◽  
Survival Function ◽  
Reference Population ◽  
Years Of Life Lost ◽  
Aged Patients ◽  
Content Type ◽  
The Mean

Purpose The purpose of this paper is to estimate the mean life expectancy (LE) and the expected years of life lost (EYLL) for ischemic stroke and intracerebral hemorrhage. Design/methodology/approach This retrospective cohort study included 5,210 patients with a diagnosis of first ischemic stroke or intracerebral hemorrhage between 2005 and 2013 from Ramathibodi Hospital, Bangkok, Thailand. The survival of each case was followed until December 31, 2016. A semiparametric extrapolation method was applied to estimate the lifetime survival function relative to an age and sex-matched reference population. Findings Of 5,210 patients, 74.2 percent experienced ischemic stroke. About 54.3 percent were men. Mean age at diagnosis was 64.3 years. The mean LE was 12.5 years for ischemic stroke and 12.0 years for intracerebral hemorrhage. The EYLL among patients with intracerebral hemorrhage was significantly higher than among those with ischemic stroke (10.1 vs 5.7). Women were expected to lose more LE than men for both types of stroke (p-value<0.05), while younger aged patients were expected to lose more years of life than older ones. Originality/value This study fulfilled an identified need to estimate LE and EYLL among patients with ischemic stroke and intracerebral hemorrhage.

scholarly journals Risk factors, types and outcomes of arterial ischemic stroke in Polish pediatric patients: a retrospective single-center study

2021 ◽  
Vol 17 (1) ◽  
pp. 62-70 ◽  
Author(s):  
Beata Sarecka-Hujar ◽  
Ilona Kopyta ◽  
Dorota Raczkiewicz
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Pediatric Patients ◽  
Age At Onset ◽  
Neurological Complications ◽  
Arterial Ischemic Stroke ◽  
Stroke Subtype ◽  
Anterior Circulation ◽  
Post Stroke ◽  
Normal Outcome

IntroductionVarious neurological complications may occur as a consequence of arterial ischemic stroke (AIS) and have an impact on daily activity of the patients, costs of their medical care and rehabilitation. The aim of this study was to analyze risk factors, stroke symptoms and post-stroke consequences in Polish pediatric patients depending on stroke subtype.Material and methodsWe retrospectively reviewed 77 children under the age of 18 years following their first AIS. Patients were white, Polish Caucasians, recruited in the Department of Pediatric Neurology at the Medical University of Silesia in Katowice (Poland). Statistical analysis was performed using Statistica 12.0.ResultsGender differed significantly between stroke subgroups (p = 0.030). The presence of focal cerebral arteriopathy (FCA) and chronic diseases was associated with type of AIS (p = 0.003 and p = 0.050, respectively). An outcome without neurological deterioration (normal outcome) was observed in 43% of children with lacunar anterior circulation infarct (LACI). Hemiparesis was present in almost all children with total anterior circulation infarct (TACI), in two thirds of children with partial anterior circulation infarct (PACI) and in almost 50% of children with LACI or posterior circulation infarct (POCI). In every child with hemiplegia the stroke symptom evolved into hemiparesis at follow-up. Additionally, patients with a normal outcome were older at the time of AIS than those with at least one neurological consequence (OR = 0.894, p = 0.034).ConclusionsThe presence and number of neurological outcomes depend on stroke subtypes. A relation between the presence of post-stroke deficits and age at onset was observed. The odds of deficit after ischemic stroke decreases by an average of 10.6% if the child is 1 year older at the time of AIS.

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