Journal Information
Vol. 32. Issue 4.
Pages 194-198 (July - August 2021)
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Vol. 32. Issue 4.
Pages 194-198 (July - August 2021)
Case Report
Supra and infratentorial massive strokes in previously healthy young patients with SARS-CoV-2. The role of neurosurgery
Ictus masivos supra e infratentoriales en pacientes jóvenes previamente sanos con SARS-CoV-2. El rol de la neurocirugía
Fernando J. Rascón-Ramíreza,
Corresponding author
ferrascon@hotmail.com

Corresponding author.
, Ángela María Carrascosa-Granadaa, Andrés Camilo Vargas-Jiméneza, Borja Ferrández-Pujantea, Francisco Ortuño-Andérizb
a Neurosurgery Department, Universitary Hospital Clínico San Carlos, Madrid, Spain
b Neurocritical Intensive Unit, Universitary Hospital Clínico San Carlos, Madrid, Spain
Article information
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Table 1. Summary of relevant variables of young patients with stroke-COVID-19.
Abstract

The coronavirus disease 2019 (COVID-19) has amazed by its distinct forms of presentation and severity.

COVID-19 patients can develop large-scale ischemic strokes in previously healthy patients without risk factors, especially in patients who develop an acute respiratory distress syndrome (SARS-CoV-2).

We hypothesize that ischemic events are usually the result of the combined process of a pro-inflammatory and pro-coagulant state plus vascular endothelial dysfunction probably potentiated by hypoxia, hemodynamic instability, and immobilization, as reported in other cases.

To the best of our knowledge, we report the first case of partial obstruction of a vertebral artery in a patient with COVID-19.

Decompressive surgery remains a life-saving maneuver in these patients (as in other non-COVID-19 strokes) and requires further investigation.

Keywords:
Cerebrovascular disease
COVID-19
Coronavirus
Stroke
Decompressive craniectomy
Cerebellar
SARS-CoV-2
Resumen

La enfermedad por coronavirus 2019 (COVID-19) ha sorprendido por sus distintas formas de presentación y gravedad.

Los pacientes con COVID-19 pueden desarrollar accidentes cerebrovasculares isquémicos a gran escala, incluso aquellos previamente sanos, sin factores de riesgo, y especialmente los que desarrollan un síndrome de dificultad respiratoria aguda (SARS-CoV-2).

Presumimos que los eventos isquémicos son generalmente el resultado del proceso combinado de un estado proinflamatorio y procoagulante, más una posible disfunción endotelial vascular, probablemente potenciada por hipoxia, inestabilidad hemodinámica e inmovilización, como se ha reportado en otros casos.

Hasta nuestro conocimiento reportamos el primer caso de una obstrucción parcial de una arteria vertebral en un paciente con COVID-19.

La cirugía descompresiva sigue siendo una maniobra que salva vidas (como en otros accidentes cerebrovasculares que no están relacionados con la COVID-19) y requiere más investigación.

Palabras clave:
Enfermedad cerebrovascular
COVID-19
Coronavirus
Ictus
Cirugía descompresiva
Cerebelo
SARS-CoV-2

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