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Total 114 results found since Jan 2013.

Cerebral Herniation Secondary to Stroke-associated Hemorrhagic Transformation, Fulminant Cerebral Edema in Setting of COVID-19 Associated ARDS and Active Malignancy
We present the case of a very rapid neurologic and radiographic decline of a patient with an acute ischemic stroke who developed rapid fulminant cerebral edema leading to herniation in the setting of hypercarbic respiratory failure attributed to SARS-CoV-2 infection.
Source: Journal of Stroke and Cerebrovascular Diseases - October 10, 2020 Category: Neurology Authors: Katarina Dakay, Gurmeen Kaur, Stephan A. Mayer, Justin Santarelli, Chirag Gandhi, Fawaz Al-Mufti Tags: Case Report Source Type: research

Stroke and Thromboprophylaxis in the era of COVID-19
In the rapidly evolving COVID-19 pandemic, many patients presenting with acute ischemic stroke may be potentially infected with the Severe Acute Respiratory Syndrome Coronavirus (SARS CoV-2) agent. As stroke patients are often unable to give an adequate history of preceding COVID-19 symptoms, all stroke patients in areas with high prevalence of community transmission should be considered potential cases. Observational studies have suggested an increased tendency for thrombotic events in patients infected with SARS CoV-2.
Source: Journal of Stroke and Cerebrovascular Diseases - October 9, 2020 Category: Neurology Authors: Alice Ma, Carlos S. Kase, Ashkan Shoamanesh, Mohamad Abdalkader, Aleksandra Pikula, Anvitha Sathya, Luciana Catanese, Alun T. Ellis, Thanh N. Nguyen Source Type: research

Cross-Talk Between Key Players in Patients with COVID-19 and Ischemic Stroke: A  Review on Neurobiological Insight of the Pandemic
AbstractThe global pandemic of novel coronavirus disease 2019 (COVID-19) has taken the entire human race by surprise and led to an unprecedented number of mortalities worldwide so far. Current clinical studies have interpreted that angiotensin-converting enzyme 2 (ACE2) is the host receptor for severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2). In addition, ACE2 is the major component of the renin-angiotensin system. ACE2 deteriorates angiotensin II, a peptide that is responsible for the promotion of stroke. The downregulation of ACE2 further activates an immunological cascade. Thus, researchers need to explore ...
Source: Molecular Neurobiology - October 7, 2020 Category: Neurology Source Type: research

SARS ‐CoV2 disease seen through the prism of acutely decompensated chronic kidney disease and ischemic stroke: What lesson we have learned from using prophylaxis therapy of vascular thromboembolism?
Our case underlines the tight management of antithrombotic therapy in the context of acutely decompensated chronic kidney disease, ischemic stroke, and SARS ‐CoV2 infection, the development of stroke as a SARS‐CoV2 complication increase the chances of adverse outcomes that may be mitigated by a rapid recognition and institution of available treatments. AbstractOur case underlines the tight management of antithrombotic therapy in the context of acutely decompensated chronic kidney disease, ischemic stroke, and SARS ‐CoV2 infection, the development of stroke as a SARS‐CoV2 complication increase the chances of adverse...
Source: Clinical Case Reports - October 7, 2020 Category: General Medicine Authors: Asmaa Hazim, Jehanne Aasfara, Ilham Slassi, Bernard Canaud, Amal Haoudar, Abdelhamid Naitlhou, Chafik El Kettani Tags: CASE REPORT Source Type: research

Pressing Issues in COVID-19: Probable Cause to Seize SARS-CoV-2 for Its Preferential Involvement of Posterior Circulation Manifesting as Severe Posterior Reversible Encephalopathy Syndrome and Posterior Strokes ADULT BRAIN
SUMMARY: Since December 2019, a novel Severe Acute Respiratory Syndrome coronavirus 2 from China has rapidly spread worldwide. Although respiratory involvement is the mainstay of coronavirus disease 2019 (COVID-19), systemic involvement has recently drawn more attention. In particular, a number of recent articles have shed light on the nervous system as one of the possible targets. At our institution, we observed 15 patients with acute brain vascular manifestations; most interesting, we had a higher prevalence of the posterior circulation acute impairment. In our series, 7 patients had acute posterior cerebral injury: 1, h...
Source: American Journal of Neuroradiology - October 5, 2020 Category: Radiology Authors: DAmore, F., Vinacci, G., Agosti, E., Cariddi, L. P., Terrana, A. V., Vizzari, F. A., Mauri, M., Giorgianni, A. Tags: ADULT BRAIN Source Type: research

Regional Mechanical Thrombectomy Imaging Protocol in Patients Presenting with Acute Ischemic Stroke during the COVID-19 Pandemic INTERVENTIONAL
CONCLUSIONS: Chest CT provides a pragmatic, rapid additional tool for COVID-19 risk stratification among patients referred for mechanical thrombectomy. Its inclusion in a standardized regional stroke imaging protocol has enabled efficient use of hospital resources with minimal compromise or delay to the overall patient treatment schedule.
Source: American Journal of Neuroradiology - October 5, 2020 Category: Radiology Authors: Dhillon, P. S., Pointon, K., Lenthall, R., Nair, S., Subramanian, G., McConachie, N., Izzath, W. Tags: INTERVENTIONAL Source Type: research

Multiple embolic stroke on magnetic resonance imaging brain in a COVID-19 case with persistent encephalopathy
The pulmonary manifestations of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection or coronavirus disease 2019 (COVID-19) are well known. The literature on neurological manifestations and complications in patients with COVID-19 has been increasing but is still sparse. At present, there are only a few reported case reports and clinical studies on neurological manifestations of COVID-19, of which ischemic stroke is one of the most common ones. Coagulopathy and vascular endothelial dysfunction have been proposed as the complications of COVID-19 which can ultimately lead to ischemic stroke.
Source: Clinical Imaging - October 4, 2020 Category: Radiology Authors: Apoorv Prasad, Saurabh Kataria, Samiksha Srivastava, Dhairya A. Lakhani, Shitiz Sriwastava Tags: Neuroradiology Source Type: research

Potential Therapeutic Benefits of Dipyridamole in COVID-19 Patients.
CONCLUSION: Dipyridamole may substantially help improve the clinical outcomes of COVID-19 treatment. The pharmacokinetics profile of the drug is well established which makes it easier to design an appropriate therapeutic course. The drug is also generally safe, affordable, and available worldwide. Initial clinical trials have shown a substantial promise for dipyridamole in treating critically ill COVID-19 patients, yet larger randomized and controlled trials are needed to confirm this promise. PMID: 33001004 [PubMed - as supplied by publisher]
Source: Current Pharmaceutical Design - September 30, 2020 Category: Drugs & Pharmacology Authors: Aliter KF, Al-Horani RA Tags: Curr Pharm Des Source Type: research

SARS-CoV-2 infection and its association with thrombosis and ischemic stroke: A review COVID-19, thrombosis, and ischemic stroke
This review of current literature provides background to the COVID-19 pandemic, as well as an examination of potential pathophysiologic mechanisms behind development of thrombosis and ischemic stroke related to COVID-19. SARS-CoV-2 infection is well-documented to cause severe pneumonia, however, thrombosis and thrombotic complications, such as ischemic stroke, have also been documented in a variety of patient demographics. SARS-CoV-2 infection is known to cause a significant inflammatory response, as well as invasion of vascular endothelial cells, resulting in endothelial dysfunction.
Source: The American Journal of Emergency Medicine - September 28, 2020 Category: Emergency Medicine Authors: Jonathan Snell Source Type: research

SARS-CoV-2 infection and its association with thrombosis and ischemic stroke: a review
This review of current literature provides background to the COVID-19 pandemic, as well as an examination of potential pathophysiologic mechanisms behind development of thrombosis and ischemic stroke related to COVID-19. SARS-CoV-2 infection is well-documented to cause severe pneumonia, however, thrombosis and thrombotic complications, such as ischemic stroke, have also been documented in a variety of patient demographics. SARS-CoV-2 infection is known to cause a significant inflammatory response, as well as invasion of vascular endothelial cells, resulting in endothelial dysfunction.
Source: The American Journal of Emergency Medicine - September 28, 2020 Category: Emergency Medicine Authors: Jonathan Snell Source Type: research

Acute Ischemic Stroke in COVID-19: A Case-Based Systematic Review
Corona virus disease (COVID-19), caused by the severe acute respiratory syndrome coronavirus2 (SARS-CoV-2) is recognized as a global pandemic by WHO 2020 with 5,934 936 infections, 367,166 deaths and affecting over 200 countries as of 30th May 2020. Acute Ischemic Stroke (AIS) in brain is also emerging as an important neurovascular/neurological complication of COVID-19, associated with extreme immune responses leading to dysregulated coagulation system and generalized thrombo-embolic status and increased risk of AIS especially among usually less vulnerable younger adults in this cohort. Thus, in early June 2020, we aimed t...
Source: Frontiers in Neurology - September 24, 2020 Category: Neurology Source Type: research

Unfractionated Heparin in SARS-CoV-2 Pneumonia: Ischemic Stroke Case Report
We present a patient with COVID-19 pneumonia who was managed with unfractionated heparin (UFH) infusion and developed a large ischemic infarct shortly after cessation of the infusion. In retrospect, the patient's coagulation parameters were consistent with overt DIC, although some of these parameters are easily masked by the effects of UFH. These findings emphasize the importance of anticoagulation as well as its careful discontinuation, as failure to do so may result in a significant thromboembolic event.
Source: Frontiers in Neurology - September 24, 2020 Category: Neurology Source Type: research

Pharmacological and cardiovascular perspectives on the treatment of COVID-19 with chloroquine derivatives.
Abstract The novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19) and an ongoing severe pandemic. Curative drugs specific for COVID-19 are currently lacking. Chloroquine phosphate and its derivative hydroxychloroquine, which have been used in the treatment and prevention of malaria and autoimmune diseases for decades, were found to inhibit SARS-CoV-2 infection with high potency in vitro and have shown clinical and virologic benefits in COVID-19 patients. Therefore, chloroquine phosphate was first used in the treatment of COVID-19 in China. Later, under a lim...
Source: Acta Pharmacologica Sinica - September 22, 2020 Category: Drugs & Pharmacology Authors: Zhang XL, Li ZM, Ye JT, Lu J, Ye LL, Zhang CX, Liu PQ, Duan DD Tags: Acta Pharmacol Sin Source Type: research

Excess mortality due to COVID-19 in Germany
SARS-CoV-2 is transmitted by droplets and likely aerosols. The median incubation period is about 5-6 days (range 1-14 days)1 and the median age at confirmed infection in Germany is 49 years. Typical symptoms include fever, cough, anosmia, ageusia, and pneumonia. The mortality rate of COVID-19 is higher among elderly and among ethnicities other than Caucasians. Furthermore, a markedly higher mortality rate has been observed for several comorbidities including obesity class II (BMI 35 •0-39•9 kg/m2) and III (BMI 40•0+ kg/m2), uncontrolled diabetes mellitus, malignancies in the previous year, severely reduced glomerular...
Source: Journal of Infection - September 17, 2020 Category: Infectious Diseases Authors: Andreas Stang, Fabian Standl, Bernd Kowall, Bastian Brune, Juliane B öttcher, Marcus Brinkmann, Ulf Dittmer, Karl-Heinz Jöckel Source Type: research

Time of stroke onset in Coronavirus disease 2019 patients around the globe: a systematic review and analysis.
Coronavirus disease 2019 (COVID-19) rapidly became a pandemic. As of August 29th, 2020, over 24 million cases have been confirmed worldwide1. Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection is associated with diverse neurological manifestations involving both the central and peripheral nervous system2,3. In fact, reports of ischemic stroke in patients with COVID-19 have increasingly been published, suggesting an association between these conditions. It has been proposed that SARS-CoV-2 infection induces a severe inflammatory response and hypercoagulable state, making patients susceptible to thromboti...
Source: Journal of Stroke and Cerebrovascular Diseases - September 17, 2020 Category: Neurology Authors: Natalia Valencia-Enciso, M ónica Ortiz-Pereira, María Paula Zafra-Sierra, Laura Espinel-Gómez, Hernan Bayona Source Type: research

Etiologic Subtypes of Ischemic Stroke in SARS-CoV-2 Patients in a Cohort of New York City Hospitals
Conclusion: COVID-19-related ischemic events can present as small vessel occlusions, branch emboli or large vessel occlusions. The most common etiology is cryptogenic. Patients with LVO syndromes tend to be younger, male and may have elevated acute inflammatory markers.
Source: Frontiers in Neurology - September 16, 2020 Category: Neurology Source Type: research

Elevated Blood Clotting Factor Linked to Worse COVID-19 Outcomes
WEDNESDAY, Sept. 16, 2020 -- Most people now know that COVID-19 can cause blood clots, potentially leading to paralysis, stroke, heart attack and death. While it ' s not clear precisely how SARS-CoV-2 causes clots, a new study suggests that the...
Source: Drugs.com - Daily MedNews - September 16, 2020 Category: General Medicine Source Type: news

IJERPH, Vol. 17, Pages 6688: Neurological Complications of COVID-19 and Possible Neuroinvasion Pathways: A Systematic Review
Gemignani The Coronavirus Disease 2019 (COVID-19) outbreak has shocked the whole world with its unexpected rapid spread. The virus responsible for the disease, the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), enters host cells by means of the envelope spike protein, which binds to angiotensin-converting enzyme 2 receptors. These receptors are highly expressed in heart, lungs, respiratory tract epithelium, endothelial cells and brain. Since an increasing body of significant evidence is highlighting a possible neuroinvasion related to SARS-CoV-2, a state of the art on the neurological complications is n...
Source: International Journal of Environmental Research and Public Health - September 13, 2020 Category: Environmental Health Authors: Graziella Orr ù Ciro Conversano Eleonora Malloggi Francesca Francesconi Rebecca Ciacchini Angelo Gemignani Tags: Review Source Type: research

Thromboembolic disease in COVID-19 patients: A brief narrative review
AbstractCorona virus 2 (SARS-CoV2/ Severe Acute Respiratory Syndrome Corona Virus 2) infection has emerged as a global health crisis. Incidence of thromboembolic disease is reported to be high in SARS-CoV2 disease and is seen in a multitude of organ systems ranging from cutaneous thrombosis to pulmonary embolism, stroke or coronary thrombosis sometimes with catastrophic outcomes. Evidence points towards a key role of thromboembolism, hypercoagulability and over production of proinflammatory cytokines mimicking a “cytokine storm” which leads to multiorgan failure. This brief narrative review highlights the pathophysiolo...
Source: Journal of Intensive Care - September 13, 2020 Category: Intensive Care Source Type: research

Characteristics of a Diverse Cohort of Stroke Patients with SARS-CoV-2 and Outcome by Sex
Coronavirus disease 2019 (COVID-19), caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), usually presents as a respiratory illness. Neurological manifestations can be seen in 36.4% of patients.1 Patients with vascular risk factors (VRFs), including history of stroke, tend to have worse prognosis.2 COVID-19 triggers a robust inflammatory response which leads to hypercoagulability and thromboembolism.3 Reports of stroke in patients with COVID-19 are mostly limited to small case series or case reports of ischemic stroke (IS), though intracerebral hemorrhage (ICH) and subarachnoid hemorrhage (SAH) have also been reported.
Source: Journal of Stroke and Cerebrovascular Diseases - September 10, 2020 Category: Neurology Authors: G. Trifan, F.D. Goldenberg, F.C. Caprio, J. Biller, M. Schneck, A. Khaja, T. Terna, J. Brorson, C. Lazaridis, Z. Bulwa, R. Alvarado-Dyer, F.G. Saleh-Velez, S. Prabhakaran, E.M. Liotta, A. Batra, N.J. Reish, S. Ruland, M. Teitcher, W. Taylor, P. De la Pena Source Type: research

Large vessel occlusion secondary to COVID-19 hypercoagulability in a young patient: A Case Report and Literature Review
We report a case of 33-year-old African American woman with COVID-19 who developed acute malignant middle cerebral artery infarction due to thromboembolic occlusion of the left terminal internal carotid artery and middle cerebral artery stem. Mechanical thrombectomy was challenging and ultimately unsuccessful resulting in limited reperfusion of
Source: Journal of Stroke and Cerebrovascular Diseases - September 9, 2020 Category: Neurology Authors: Thomas John Pisano, Ian Hakkinen, Igor Rybinnik Source Type: research

The potential role of microvascular pathology in the neurological manifestations of coronavirus infection
We present the hypothesis that pre-existing vascular damage (due to aging, cardiovascular disease, diabetes, hypertension or other conditions) facilitates infiltration of the virus into the central nervous system (CNS), increasing neuro-inflammation and the likelihood o f neurological symptoms. We also discuss the role of a neuroinflammatory cytokine profile in both blood–brain barrier dysfunction and macrovascular disease (e.g. ischemic stroke and thromboembolism). Future studies are needed to better understand the involvement of the microvasculature in coronavi rus neuropathology, and to test the diagnostic potential o...
Source: Fluids and Barriers of the CNS - September 9, 2020 Category: Neuroscience Source Type: research

Intraluminal Carotid Artery Thrombus in COVID-19: Another Danger of Cytokine Storm? EXTRACRANIAL VASCULAR
We report a series of 6 patients with COVID-19 with acute ischemic stroke due to intraluminal carotid artery thrombus presenting during an 8-day period. Six patients were included (5 men) with a mean age of 65.8 years (range, 55–78 years). COVID-19 was diagnosed by detection of Severe Acute Respiratory Syndrome coronavirus 2 in 5 patients and was presumed due to typical clinical and imaging findings in 1 patient. All patients had vascular risk factors including diabetes (83%), hyperlipidemia (100%), and smoking (17%). Four patients presented with large infarcts with initial NIHSS scores of 24–30. During their h...
Source: American Journal of Neuroradiology - September 8, 2020 Category: Radiology Authors: Mohamud, A. Y., Griffith, B., Rehman, M., Miller, D., Chebl, A., Patel, S. C., Howell, B., Kole, M., Marin, H. Tags: EXTRACRANIAL VASCULAR Source Type: research

ECMO support in SARS-CoV2 multisystem inflammatory syndrome in children in a child.
In this report, we describe the case of a 5-year-old male with SARS-CoV-2 associated MIS-C with progressive respiratory failure and vasoplegic shock requiring extracorporeal support. At presentation, reverse transcription-polymerase chain reaction (RT-PCR) testing for SARS-CoV-2 was negative, however, SARS-CoV2 antibody testing was positive. Multiple inflammatory markers and cardiac biomarkers were elevated. Echocardiogram demonstrated mildly depressed left ventricular function and no coronary anomalies noted. The patient required mechanical ventilation, vasopressors, and eventually extracorporeal membrane oxygenation (ECM...
Source: Perfusion - September 8, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Kaushik S, Ahluwalia N, Gangadharan S, Esperenza M, Murthy R, Ofori-Amanfo G, Aydin SI Tags: Perfusion Source Type: research

Anticoagulation use and Hemorrhagic Stroke in SARS-CoV-2 Patients Treated at a New York Healthcare System
ConclusionWe observed an overall low rate of imaging-confirmed hemorrhagic stroke among patients hospitalized with COVID-19. Most hemorrhages in patients with COVID-19 infection occurred in the setting of therapeutic anticoagulation and were associated with increased mortality. Further studies are needed to evaluate the safety and efficacy of therapeutic anticoagulation in patients with COVID-19.
Source: Neurocritical Care - August 23, 2020 Category: Neurology Source Type: research

Association of Coronavirus Disease 2019 and Stroke: A Rising Concern
The severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) causes the coronavirus disease 2019 (COVID-19). It quickly became pandemic, and so did a new concern about COVID-19 infections increasing the risk for cerebrovascular diseases. There is an association between COVID-19 illness in people and acute stroke. Several chemical, mechanical, and/or inflammatory central nervous system pathologies are proposed to explain how this viral infection might induce acute cerebrovascular disease. Timely available evaluation and/or intervention is imperative for patients with concerns about acute cerebrovascular issues.Neuroepidemiology
Source: Neuroepidemiology - August 13, 2020 Category: Epidemiology Source Type: research

Malignant Cerebral Ischemia in A COVID-19 Infected Patient: Case Review and Histopathological Findings
Severe acute respiratory syndrome coronavirus (SARS-CoV-2) is responsible for an unprecedented worldwide pandemic that has severely impacted the United States. As the pandemic continues, a growing body of evidence suggests that infected patients may develop significant coagulopathy with resultant thromboembolic complications including deep vein thrombosis, pulmonary embolism, myocardial infarction, and ischemic stroke. However, this data is limited and comes from recent small case series and observational studies on stroke types, mechanisms, and outcomes.
Source: Journal of Stroke and Cerebrovascular Diseases - August 4, 2020 Category: Neurology Authors: Smit D. Patel, Ryan Kollar, Patrick Troy, Xianyuan Song, Mohammad Khaled, Augusto Parra, Mubashir Pervez Source Type: research

Management of acute stroke and urgent neurointerventional procedures during COVID-19 pandemic: recommendations on the Scientific Department on Cerebrovascular Diseases of the Brazilian Academy of Neurology, Brazilian Society of Cerebrovascular Diseases and Brazilian Society of Neuroradiology
ABSTRACT Introduction: Although the 2019 severe acute respiratory syndrome coronavirus 2 infection (SARS-CoV-2, COVID-19) pandemic poses new challenges to the healthcare system to provide support for thousands of patients, there is special concern about common medical emergencies, such as stroke, that will continue to occur and will require adequate treatment. The allocation of both material and human resources to fight the pandemic cannot overshadow the care for acute stroke, a time-sensitive emergency that with an inefficient treatment will further increase mortality and long-term disability. Objective: This paper summar...
Source: Arquivos de Neuro-Psiquiatria - July 31, 2020 Category: Neurology Source Type: research

Posterior Reversible Encephalopathy Syndrome in Patients with Coronavirus Disease 2019: Two Cases and a Review of the Literature
Central nervous system (CNS) manifestations of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection include encephalopathy, encephalitis, meningitis, acute disseminated encephalomyelitis, and stroke [1], both as a result of direct viral invasion of the central nervous system [2 –5] and as a consequence of critical illness and systemic infection [6]. Coronavirus disease 2019 (COVID-19) may also cause significant changes in endothelial morphology, including disruption of intercellular junctions, cell swelling, and a loss of contact with the basal membrane [7].
Source: Journal of Stroke and Cerebrovascular Diseases - July 29, 2020 Category: Neurology Authors: Pria Anand, K. H.Vincent Lau, David Y Chung, Deepti Virmani, Anna M. Cervantes-Arslanian, Asim Mian, Courtney E. Takahashi Source Type: research

COVID-19 Fears Keep Many Hispanic Adults With Stroke, MI Home COVID-19 Fears Keep Many Hispanic Adults With Stroke, MI Home
More than half of Hispanic adults would be afraid to go to a hospital for a possible heart attack or stroke because they might get infected with SARS-CoV-2, according to a new survey.Medscape Medical News
Source: Medscape Cardiology Headlines - July 29, 2020 Category: Cardiology Tags: Neurology & Neurosurgery News Source Type: news

Care for Patients with Stroke During the COVID-19 Pandemic: Physical Therapy and Rehabilitation Suggestions for Preventing Secondary Stroke
Infection with the novel severe acute respiratory syndrome coronavirus 2 causes the development of the novel 2019 coronavirus disease (COVID-19) and associated clinical symptoms, which typically presents as an upper respiratory syndrome such as pneumonia. Growing evidence indicates an increased prevalence of neurological involvement (e.g., in the form of stroke) during virus infection. COVID-19 has been suggested to be more than a lung infection because it affects the vasculature of the lungs and other organs and increases the risk of thrombosis.
Source: Journal of Stroke and Cerebrovascular Diseases - July 21, 2020 Category: Neurology Authors: Chien-Chih Wang, Jian-Kang Chao, Mong-Lien Wang, Yi-Ping Yang, Chien-Shiu Chien, Wei-Yi Lai, Yi-Chiang Yang, Yu-Hui Chang, Chen-Liang Chou, Chung-Lan Kao Source Type: research

Acute Stroke as the Presenting Symptom of SARS-CoV-2 Infection in a Young Patient with Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy
Coronavirus disease of 2019 (COVID-19) has currently reached pandemic levels and neurological manifestations, including stroke as the initial presentation, have been increasingly recognized (1-3). Majority of the reported ischemic strokes are large vessel occlusion or embolic appearing strokes and are frequently described in critically ill patients with severe COVID-19 disease (2), but small ischemic strokes have also been reported (4). Recently, stroke as the presenting symptom in younger patients (
Source: Journal of Stroke and Cerebrovascular Diseases - July 18, 2020 Category: Neurology Authors: Gabriela Trifan, Maureen Hillmann, Fernando D. Testai Source Type: research

COVID-19 and Stroke: Casual or Causal Role?
We present a case of stroke in a 62-year-old COVID-19-positive patient, with multiple vascular risk factors. The patient arrived 1 h after onset of symptoms, was treated with recombinant tissue plasminogen activator (rtPA) with improvement of neurologic deficits, and later developed right foot arterial ischemia (recanalized by balloon catheter angioplasty) and left arm superficial venous thrombosis. A control computed tomography (CT) scan 7 days after onset showed hemorrhagic transformation of ischemic lesion without mass effect. However, respiratory and neurologic conditions improved so that the patient was discharged to ...
Source: Cerebrovascular Diseases - July 7, 2020 Category: Neurology Source Type: research

Universal laboratory testing for SARS-CoV-2 in hyperacute stroke during the COVID-19 pandemic
The coronavirus disease 2019 (COVID-19) pandemic necessitates organizational and structural adjustments to local health care systems to protect medical professionals and patients from infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (1). Particularly older individuals and those with cardiovascular comorbidities are thought to be at increased risk of COVID-19 (2). Consequently, stroke patients can be considered an at-risk population and might benefit from infection control screens at hospital entry (3,4).
Source: Journal of Stroke and Cerebrovascular Diseases - June 19, 2020 Category: Neurology Authors: Kristian Barlinn, Timo Siepmann, Lars-Peder Pallesen, Simon Winzer, Annahita Sedghi, Percy Schroettner, Kristina Hochauf-Stange, Alexandra Prakapenia, Haidar Moustafa, Katja de With, Jennifer Linn, Heinz Reichmann, Jessica Barlinn, Volker Puetz Tags: Original Article Source Type: research

Stroke and COVID19: not only a large-vessel disease
Recent evidence has underlined the association between large-vessel stroke and COVID-19, probably due to a proinflammatory and prothrombotic microenvironment induced by SARS-CoV-2. Here, we report the case of a young fit woman affected by COVID-19 without any flu-like symptom, who suffered from speech disorder and left hemiparesis. Brain magnetic resonance evidenced two small acute brain infarctions in right perirolandic cortex without signs of previous ischemic lesions and hemorrhagic infarction.
Source: Journal of Stroke and Cerebrovascular Diseases - June 18, 2020 Category: Neurology Authors: Giovanni Frisullo, Simone Bellavia, Irene Scala, Carla Piano, Roberta Morosetti, Valerio Brunetti, Paolo Calabresi, Giacomo Della Marca Tags: Case Report Source Type: research

Potential mechanisms of hemorrhagic stroke in elderly COVID-19 patients.
Abstract The novel severe acute respiratory syndrome coronavirus 2 is the causative agent of coronavirus disease 2019, a new human infectious disease. While fever, cough, and respiratory distress are typical first symptoms, a fraction of those affected present instead with neurological symptoms suggestive of central nervous system compromise. This review summarizes the potential contribution of coronavirus disease 2019 to hemorrhagic stroke in the elderly and proposes possible mechanisms. Reports show that the most affected patients have underlying chronic diseases such as hypertension and diabetes, which are two ...
Source: Aging - June 10, 2020 Category: Biomedical Science Authors: Wang H, Tang X, Fan H, Luo Y, Song Y, Xu Y, Chen Y Tags: Aging (Albany NY) Source Type: research

COVID-19 and \ stroke: Incidental, triggered or causative
Rohit Bhatia, M V. Padma SrivastavaAnnals of Indian Academy of Neurology 2020 23(3):318-324 Stroke is a serious neurological complication observed during the ongoing COVID-19 (coronavirus associated disease 2019) pandemic caused by SARS-CoV-2 (severe acute respiratory syndrome, corona virus 2) and includes both ischemic stroke and intracerebral haemorrhage. We reviewed factors that could potentially contribute to the occurrence of stroke among patients with COVID-19. There could be an interaction between the conventional risk factors of stroke, infection, systemic inflammatory response and plaque destabilisation. Inflamma...
Source: Annals of Indian Academy of Neurology - June 9, 2020 Category: Neurology Authors: Rohit Bhatia M V. Padma Srivastava Source Type: research

COVID-19: Stroke Admissions, Emergency Department Visits, and Prevention Clinic Referrals.
Abstract We assessed the impact of the coronavirus disease 19 (COVID-19) pandemic on code stroke activations in the ED, stroke unit admissions, and referrals to the stroke prevention clinic at London's regional stroke center, serving a population of 1.8 million in Ontario, Canada. We found a 20% drop in the number of code strokes in 2020 compared to 2019, immediately after the first cases of COVID-19 were officially confirmed. There were no changes in the number of stroke admissions and there was a 22% decrease in the number of clinic referrals, only after the provincial lockdown. Our findings suggest that the dec...
Source: The Canadian Journal of Neurological Sciences - May 25, 2020 Category: Neurology Authors: Bres Bullrich M, Fridman S, Mandzia JL, Mai LM, Khaw A, Vargas Gonzalez JC, Bagur R, Sposato LA Tags: Can J Neurol Sci Source Type: research

Unprotected stroke management in an undiagnosed case of Severe Acute Respiratory Syndrome Coronavirus 2 infection
We report the case of a 79-year-old woman, who was admitted for a wake-up stroke due to occlusion of the left middle cerebral artery. She was treated outside the COVID-19-dedicated track of the hospital because she had no concomitant signs or symptoms suggestive of SARS-CoV-2 infection nor recent contact with other infected individuals.
Source: Journal of Stroke and Cerebrovascular Diseases - May 22, 2020 Category: Neurology Authors: Claudia Papi, Gregorio Spagni, Andrea Alexandre, Paolo Calabresi, Giacomo Della Marca, Aldobrando Broccolini Source Type: research

COVID-19 patients may have lower stroke rates than previously suggested
(NYU Langone Health / NYU School of Medicine) Fewer people than previously reported suffer from stroke as a result of COVID-19, a new analysis finds. However, strokes that accompany the pandemic virus, SARS-CoV-2, appear to be more severe.
Source: EurekAlert! - Infectious and Emerging Diseases - May 20, 2020 Category: Infectious Diseases Source Type: news

Stroke in patients with SARS-CoV-2 infection: case series
ConclusionsBoth ischemic and hemorrhagic stroke can complicate the course of COVI-19 infection. In our series, stroke developed mostly in patients with severe pneumonia and multiorgan failure, liver enzymes and LDH were markedly increased in all cases, and the outcome was poor.
Source: Journal of Neurology - May 19, 2020 Category: Neurology Source Type: research

Falling stroke rates during COVID-19 pandemic at a comprehensive stroke center
The novel human coronavirus, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), began in Wuhan, China in December of 2019 and has led to a pandemic, accounting for more than 2.4 million worldwide infections and more than 160,000 deaths (as of April 20, 2020).1,2
Source: Journal of Stroke and Cerebrovascular Diseases - May 13, 2020 Category: Neurology Authors: J.E. Siegler, M.E. Heslin, L. Thau, A. Smith, T.G. Jovin Source Type: research

Falling stroke rates during COVID-19 pandemic at a Comprehensive Stroke Center: Cover title: Falling stroke rates during COVID-19
The novel human coronavirus, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), began in Wuhan, China in December of 2019 and has led to a pandemic, accounting for more than 2.4 million worldwide infections and more than 160,000 deaths (as of April 20, 2020).1,2
Source: Journal of Stroke and Cerebrovascular Diseases - May 13, 2020 Category: Neurology Authors: J.E. Siegler, M.E. Heslin, L. Thau, A. Smith, T.G. Jovin Source Type: research

Coronavirus Disease 2019 and Stroke: Clinical Manifestations and Pathophysiological Insights
An outbreak of an acute respiratory illness of unknown cause started in Wuhan, Hubei province, China on December 12, 2019.1,2 A new strain of coronavirus, named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was identified in these patients. Subsequently, the identified acute respiratory illness was named coronavirus disease 2019 (COVID-19). Soon thereafter, the COVID-19 epidemic in China became a pandemic with a significant burden on healthcare and the world-wide economy. SARS-CoV-2 has been shown to be a distinct class of the beta coronaviruses (Beta-CoVs) with a 79.5% gene sequence homology to the severe ...
Source: Journal of Stroke and Cerebrovascular Diseases - May 10, 2020 Category: Neurology Authors: Afshin A. Divani, Sasan Andalib, Mario Di Napoli, Simona Lattanzi, M. Shazam Hussain, Jos é Biller, Louise D. McCullough, M. Reza Azarpazhooh, Alina Seletska, Stephan A. Mayer, Michel Torbey Tags: Review Article Source Type: research

Management of acute ischemic stroke in patients with COVID-19 infection: Insights from an international panel
A corona virus (SARS-CoV-2) has infected 986,776 persons as of April 2nd, 2020 over a period of 4  months. There is a possibility that Coronavirus Disease 2019 (COVID-19) infection increases the risk of stroke similar to other respiratory tract infections [1]. Approximately 5% of hospitalized patients with COVID-19 infection suffer from stroke with over 80% of them being ischemic stroke [2]. T he reported mortality is 39% in patient with stroke [2] and COVID-19 infection which is much higher than the mortality observed in patients with stroke without COVID-19 infection [3].
Source: The American Journal of Emergency Medicine - May 9, 2020 Category: Emergency Medicine Authors: Adnan I. Qureshi, Foad Abd-Allah, Fahmi Alsenani, Emrah Aytac, Afshin Borhani-Haghighi, Alfonso Ciccone, Camilo R. Gomez, Erdem Gurkas, Chung Y. Hsu, Vishal Jani, Liqun Jiao, Adam Kobayashi, Jun Lee, Jahanzeb Liaqat, Mikael Mazighi, Rajsrinivas Parthasara Source Type: research

Interventional Stroke Care in the Era of COVID-19
The current coronavirus disease (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 has led to immense strain on healthcare systems and workers. Patients with severe symptoms of COVID-19 may also present with acute neurological emergencies such as ischemic stroke. Ischemic stroke in these patients may result from COVID-19 related complications or decompensation of previously asymptomatic cerebrovascular disorders, or concurrent ischemic stroke from common stroke risk factors in a patient with COVID-19. Acute ischemic stroke patients with large vessel occlusions require emergent triage, intensive c...
Source: Frontiers in Neurology - May 7, 2020 Category: Neurology Source Type: research

COVID-19-Related Stroke
AbstractThe COVID-19 pandemic is associated with neurological symptoms and complications including stroke. There is hypercoagulability associated with COVID-19 that is likely a “sepsis-induced coagulopathy” and may predispose to stroke. The SARS-CoV-2 virus binds to angiotensin-converting enzyme 2 (ACE2) present on brain endothelial and smooth muscle cells. ACE2 is a key part of the renin angiotensin system (RAS) and a counterbalance to angiotensin-converting enzyme 1 (ACE1) and angiotensin II. Angiotensin II is proinflammatory, is vasoconstrictive, and promotes organ damage. Depletion of ACE2 by SARS-CoV-2 may tip the...
Source: Translational Stroke Research - May 6, 2020 Category: Neurology Source Type: research

Call to Action: SARS-CoV-2 and Cerebrovascular DisordErs (CASCADE)
The novel severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2), now named coronavirus disease 2019 (COVID-19), may change the risk of stroke through an enhanced systemic inflammatory response, hypercoagulable state, and endothelial damage in the cerebrovascular system. Moreover, due to the current pandemic, some countries have prioritized health resources towards COVID-19 management, making it more challenging to appropriately care for other potentially disabling and fatal diseases such as stroke.
Source: Journal of Stroke and Cerebrovascular Diseases - May 6, 2020 Category: Neurology Authors: Shahram Abootalebi, Benjamin M. Aertker, Mohammad Sobhan Andalibi, Negar Asdaghi, Ozlem Aykac, M. Reza Azarpazhooh, M. Cecilia Bahit, Kristian Barlinn, Hamidon Basri, Reza Bavarsad Shahripour, Anna Bersano, Jose Biller, Afshin Borhani-Haghighi, Robert D. Source Type: research

Stroke priorities during COVID-19 outbreak: acting both fast and safe
While the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) spreads all over the world, the healthcare systems are facing the dramatic challenge of simultaneously fight against the outbreak and life-threating emergencies.In this biological setting, emergency departments and neurovascular teams are exposed to high risk of infection and should therefore be prepared to deal with neurological emergencies safely.The purpose of this article is to analyze the current evidence on COVID-19 in the context of acute ischemic stroke and to describe the model of behavior we are putting into action to maintain the stroke pathw...
Source: Journal of Stroke and Cerebrovascular Diseases - May 4, 2020 Category: Neurology Authors: Alessandro Pedicelli, Iacopo Valente, Fabio Pilato, Marisa Distefano, Cesare Colosimo Source Type: research

COVID-19 presenting as stroke.
CONCLUSIONS: Timely assessment and hyperacute treatment is the key to minimize mortality and morbidity of patients with acute stroke. Stroke teams should be wary of the fact that COVID-19 patients can present with cerebrovascular accidents and dawn appropriate personal protective equipment in every suspected patient. Further studies are urgently needed for a comprehensive understanding of the neurological pathology of COVID-19 and its effects on the nervous system. PMID: 32360439 [PubMed - as supplied by publisher]
Source: Brain, Behavior, and Immunity - April 27, 2020 Category: Neurology Authors: Avula A, Nalleballe K, Narula N, Sapozhnikov S, Dandu V, Toom S, Glaser A, Elsayegh D Tags: Brain Behav Immun Source Type: research