Intracranial Aneurysm Rupture after SARS-CoV2 Infection : Case Report and Review of Literature

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Khan , D , Naderi , S , Ahmadi , M , Ghorbani , A , Cornelius , J F , Haenggi , D & Muhammad , S 2022 , ' Intracranial Aneurysm Rupture after SARS-CoV2 Infection : Case Report and Review of Literature ' , Pathogens , vol. 11 , no. 6 , 617 .

Title: Intracranial Aneurysm Rupture after SARS-CoV2 Infection : Case Report and Review of Literature
Author: Khan, Dilaware; Naderi, Soheil; Ahmadi, Mostafa; Ghorbani, Askar; Cornelius, Jan Frederick; Haenggi, Daniel; Muhammad, Sajjad
Contributor organization: HUS Neurocenter
University of Helsinki
Neurokirurgian yksikkö
Date: 2022-06
Language: eng
Number of pages: 9
Belongs to series: Pathogens
ISSN: 2076-0817
Abstract: Background: SARS-CoV virus infection results in a dysbalanced and severe inflammatory response with hypercytokinemia and immunodepression. Viral infection triggers systemic inflammation and the virus itself can potentially cause vascular damage, including blood-brain barrier (BBB) disruption and alterations in the coagulation system, which may result in cardiovascular and neurovascular events. Here, we review the literature and present a case of COVID-19 infection leading to an aneurysmal subarachnoid haemorrhage (aSAH). Case Description: A 61-year-old woman presented with dyspnea, cough, and fever. She had a history of hypertension and was overweight with a body mass-index of 34. There was no history of subarachnoid hemorrhage in the family. Due to low oxygen saturation (89%) she was admitted into ICU. A chest CT showed a typical picture of COVID-19 pneumonia. The PCR-based test of an oropharyngeal swab was COVID-19-positive. In addition to oxygen support she was prescribed with favipiravir and hydroxychloroquine. She experienced a sudden headache and lost consciousness on the second day. Computer tomography (CT) with CT-angiography revealed a subarachnoid haemorrhage in the basal cisterns from a ruptured anterior communicating artery aneurysm. The aneurysm was clipped microsurgically through a left-sided standard pterional approach and the patient was admitted again to the intensive care unit for further intensive medical treatment. Post-operatively, the patient showed slight motor dysphasia. No other neurological deficits. Conclusion: Systemic inflammation and ventilator support-associated blood pressure fluctuations may trigger aneurysmal subarachnoid haemorrhage secondary to COVID-19 infection. COVID-19 infection could be considered as one of the possible risk factors leading to instability and rupture of intracranial aneurysm.
Subject: COVID-19
neurovascular complications
11832 Microbiology and virology
Peer reviewed: Yes
Rights: cc_by
Usage restriction: openAccess
Self-archived version: publishedVersion

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