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Pathomechanism and Management of Stroke in COVID-19: Review of Immunopathogenesis, Coagulopathy, Endothelial Dysfunction, and Downregulation of ACE2
J Clin Neurol. 2021 Apr;17(2):155-163. doi: 10.3988/jcn.2021.17.2.155.ABSTRACTCoronavirus disease 2019 (COVID-19) can reportedly manifest as an acute stroke, with most cases presenting as large vessel ischemic stroke in patients with or without comorbidities. The exact pathomechanism of stroke in COVID-19 remains ambiguous. The findings of previous studies indicate that the most likely underlying mechanisms are cerebrovascular pathological conditions following viral infection, inflammation-induced endothelial dysfunction, and hypercoagulability. Acute endothelial damage due to inflammation triggers a coagulation cascade, t...
Source: Journal of Clinical Neurology - April 9, 2021 Category: Neurology Authors: Putu Lohita Rahmawati Kumara Tini Ni Made Susilawathi I A Sri Wijayanti Dpg Purwa Samatra Source Type: research

Clinical Outcome of Acute Ischemic Strokes in Patients with COVID-19
Conclusion: In this study, patients with AIS infected by SARS-CoV-2 showed a poorer early outcome than COVID − ones. However, when compared to other factors, COVID-19 was not a significant predictor of poor outcome. Vascular morbidity and mortality rates were significantly higher in the COVID+ group compared with the COVID− group.Cerebrovasc Dis
Source: Cerebrovascular Diseases - March 30, 2021 Category: Neurology Source Type: research

Stroke Care during the COVID-19 Pandemic: International Expert Panel Review
This study, prepared by a large international panel of stroke experts, assesses the rapidly growing research and personal experience with COVID-19 stroke and offers recommendations for stroke management in this challenging new setting: modifications needed for prehospital emergency rescue and hyperacute care; inpatient intensive or stroke units; posthospitalization rehabilitation; follow-up including at-risk family and community; and multispecialty departmental developments in the allied professions.Summary: The severe acute respiratory syndrome coronavirus 2 uses spike proteins binding to tissue angiotensin-converting enz...
Source: Cerebrovascular Diseases - March 23, 2021 Category: Neurology Source Type: research

Acute Stroke Care during the COVID-19 Pandemic: Reduction in the Number of Admissions of Elderly Patients and Increase in Prehospital Delays
Conclusion: We observed a reduction in the number of acute strokes and TIAs admitted during the COVID-19 period. This drop affected especially elderly patients, and despite a delay in their arrival to the emergency department, the proportion of patients treated with recanalization therapies was preserved.Cerebrovasc Dis
Source: Cerebrovascular Diseases - March 17, 2021 Category: Neurology Source Type: research

Impact of SARS-CoV-2 on reperfusion therapies for acute ischemic stroke in Lombardy, Italy: the STROKOVID network
AbstractWhether and how SARS-CoV-2 outbreak affected in-hospital acute stroke care system is still matter of debate. In the setting of the STROKOVID network, a collaborative project between the ten centers designed as hubs for the treatment of acute stroke during SARS-CoV-2 outbreak in Lombardy, Italy, we retrospectively compared clinical features and process measures of patients with confirmed infection (COVID-19) and non-infected patients (non-COVID-19) who underwent reperfusion therapies for acute ischemic stroke. Between March 8 and April 30, 2020, 296 consecutive patients [median age, 74 years (interquartile range (IQ...
Source: Journal of Neurology - March 8, 2021 Category: Neurology Source Type: research

Clinical features of neurological patients with coronavirus 2019: an observational study of one centre.
CONCLUSIONS: We studied a select group of patients (elderly, with comorbidities, and moderate or severe COVID-19 course). Pre-existing neurological disorders were additionally associated with a poorer prognosis and a high fatality rate (30%). Dementia and CNS vascular disorder were the most frequent pre-existing neurological conditions. The neurological symptoms of COVID-19 were various. We observed impaired consciousness, dizziness, headache, nausea, myalgia, psychomotor agitation and slowness, delirium, and psychoses. Further analysis is needed to elucidate the incidence of COVID-19 neurological complications. PMID:...
Source: Neurologia i Neurochirurgia Polska - February 2, 2021 Category: Neurology Authors: Zielińska-Turek J, Jasińska A, Kołakowska J, Szadurska J, Kosior DA, Dorobek M Tags: Neurol Neurochir Pol Source Type: research

Neurological symptoms, manifestations, and complications associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease 19 (COVID-19)
AbstractSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel coronavirus, is responsible for the outbreak of coronavirus disease 19 (COVID-19) and was first identified in Wuhan, China in December 2019. It is evident that the COVID-19 pandemic has become a challenging world issue. Although most COVID-19 patients primarily develop respiratory symptoms, an increasing number of neurological symptoms and manifestations associated with COVID-19 have been observed. In this narrative review, we elaborate on proposed neurotropic mechanisms and various neurological symptoms, manifestations, and complications of COVI...
Source: Journal of Neurology - January 23, 2021 Category: Neurology Source Type: research

Central and peripheral nervous system complications of COVID-19: a prospective tertiary center cohort with 3-month follow-up
ConclusionCNS  and PNS complications were common in hospitalized COVID-19 patients, particularly in the ICU, and often attributable to critical illness. When COVID-19 was the primary cause for neurological disease, no signs of viral neurotropism were detected, but laboratory changes suggested autoimmune-mediate d mechanisms.
Source: Journal of Neurology - January 13, 2021 Category: Neurology Source Type: research

Stroke and digital technology: a wake-up call from COVID-19 pandemic
ConclusionThe global emergency represented by the COVID-19 pandemic can be the stimulus to accelerate the digitalization process in the field of stroke for the use of new methods on a large scale.
Source: Neurological Sciences - January 12, 2021 Category: Neurology Source Type: research

Effects of the COVID-19 pandemic on reperfusion therapy for acute ischemic stroke patients in Huizhou City, China
ConclusionDuring the COVID-19 pandemic in 2020, the number of AIS patients receiving reperfusion therapy significantly decreased when compared to the same period in 2019. The patients ’ condition increased severity, ODT increased, and the DNT decreased. DPT was not significant for self-visiting and ambulance patients. Moderate to severe stroke patients were more likely to utilize ambulance services.
Source: Neurological Sciences - January 7, 2021 Category: Neurology Source Type: research

Clinical, cerebrospinal fluid, and neuroimaging findings in COVID-19 encephalopathy: a case series
ConclusionIn our consecutive series with 43 encephalopathy cases, neuroimaging and CSF analysis did not support the role of direct viral CNS invasion or CNS inflammation as the cause of encephalopathy.
Source: Neurological Sciences - January 7, 2021 Category: Neurology Source Type: research

Acute Ischemic Stroke in SARS-CoV, MERS-CoV, SARS-CoV-2: Neurorehabilitation Implications of Inflammation Induced Immunological Responses Affecting Vascular Systems
Coronaviruses (CoVs) are enveloped RNA viruses and have been shown to cause mild to severe respiratory infections in humans, with some severe cases inducing neurological manifestations. The lethality and Neurological effects of the Severe Acute Respiratory Syndrome (SARS-CoV), Middle-East Respiratory Syndrome (MERS-CoV), and recently the Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) have been well documented though currently there is little literature regarding long term effects and the implications for neurorehabilitation. SARS-CoV-2 and MERS-CoV have been linked to the infection associated inflammatory cyt...
Source: Frontiers in Neurology - December 22, 2020 Category: Neurology Source Type: research

Telemedicine in neurology: current evidence
Conclusion: Current evidence supports that teleneurology can be a tool to increase care for patients suffering from neurological diseases.RESUMO Introdu ção: A telemedicina surge pela primeira vez na neurologia como uma ferramenta para facilitar o acesso ao tratamento do acidente vascular cerebral (AVC) Agudo. Mais recentemente, inúmeras evidências têm surgido acerca da eficácia e da segurança do uso da telemedicina em várias outras áreas d a neurologia. Com o advento da pandemia de COVID-19 e a necessidade de isolamento social, as autoridades brasileiras flexibilizaram a regulamentação da telemedicina, permitin...
Source: Arquivos de Neuro-Psiquiatria - December 14, 2020 Category: Neurology Source Type: research

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