Acute confusional state as a prognostic sign of COVID-19 large-vessel occlusion (LVO).
infectious diseases
neuroimaging
neurology
respiratory medicine
stroke
Journal
BMJ case reports
ISSN: 1757-790X
Titre abrégé: BMJ Case Rep
Pays: England
ID NLM: 101526291
Informations de publication
Date de publication:
23 Feb 2021
23 Feb 2021
Historique:
entrez:
24
2
2021
pubmed:
25
2
2021
medline:
27
2
2021
Statut:
epublish
Résumé
COVID-19 is well known for its respiratory symptoms, but severe presentations can alter haemostasis, causing acute end-organ damage with poor outcomes. Among its various neurological presentations, cerebrovascular events often present as small-vessel strokes. Although uncommon, in predisposed individuals, large-vessel occlusions (LVOs) can occur as a possible consequence of direct viral action (viral burden or antigenic structure) or virus-induced cytokine storm. Subtle presentations and complicated stroke care pathways continue to exist, delaying timely care. We present a unique case of COVID-19 LVO manifesting as an acute confusional state in an elderly man in April 2020. CT angiography revealed 'de novo' occlusions of the left internal carotid artery and proximal right vertebral artery, effectively blocking anterior and posterior circulations. Delirium can lead to inaccurate stroke scale assessments and prolong initiation of COVID-19 stroke care pathways. Future studies are needed to look into the temporal relationship between confusion and neurological manifestations.
Identifiants
pubmed: 33622754
pii: 14/2/e240536
doi: 10.1136/bcr-2020-240536
pmc: PMC7907863
pii:
doi:
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© BMJ Publishing Group Limited 2021. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
Références
JAMA. 2020 Sep 22;324(12):1139-1140
pubmed: 32960246
BMJ. 2019 Jan 23;364:l1
pubmed: 30674465
Stroke. 2020 Jul;51(7):e124-e127
pubmed: 32396456
Stroke. 2020 Sep;51(9):2656-2663
pubmed: 32755349
ACS Chem Neurosci. 2020 Apr 1;11(7):995-998
pubmed: 32167747
Am J Cardiol. 2020 Sep 1;130:169-170
pubmed: 32690214
JAMA Netw Open. 2020 Nov 2;3(11):e2029540
pubmed: 33211114
Thromb Res. 2020 Sep;193:107-109
pubmed: 32534327
Ann Indian Acad Neurol. 2008 Oct;11(4):207-20
pubmed: 19893676
BMJ Case Rep. 2020 Aug 18;13(8):
pubmed: 32816935
Future Healthc J. 2020 Jun;7(2):169-173
pubmed: 32550287
N Engl J Med. 2020 Jul 23;383(4):400-401
pubmed: 32383831
J Thromb Haemost. 2020 Aug;18(8):2031-2033
pubmed: 32464707
Front Neurol. 2020 Apr 21;11:353
pubmed: 32373061
J Thromb Thrombolysis. 2020 Nov;50(4):799-808
pubmed: 32696172
J Neurol. 2004 Oct;251(10):1227-31
pubmed: 15503102
Br J Neurosurg. 2020 Aug 5;:1-4
pubmed: 32755343
Stroke. 2020 May;51(5):1356-1357
pubmed: 32228369
Eur J Case Rep Intern Med. 2020 May 26;7(6):001732
pubmed: 32523931
J Clin Neurosci. 2020 Jul;77:234-236
pubmed: 32414622
AJNR Am J Neuroradiol. 2020 Dec;41(12):2263-2268
pubmed: 32855182
Neurosurgery. 2019 Jul 1;85(suppl_1):S4-S8
pubmed: 31197329
Stroke. 2007 Nov;38(11):2979-84
pubmed: 17901381
Stroke. 2020 Aug;51(8):2587-2592
pubmed: 32716826
Lancet Infect Dis. 2020 May;20(5):533-534
pubmed: 32087114
eNeurologicalSci. 2020 Jun 06;20:100247
pubmed: 32566772
Cureus. 2020 May 14;12(5):e8121
pubmed: 32426200
J Card Surg. 2020 Nov;35(11):3173-3175
pubmed: 32740953
J Thromb Thrombolysis. 2020 Apr 3;:
pubmed: 32246317
Stroke. 2020 Aug;51(8):2593-2596
pubmed: 32716828
Eur J Neurol. 2020 Nov;27(11):2308-2311
pubmed: 32761999
eNeurologicalSci. 2020 Jun 16;20:100250
pubmed: 32632380
QJM. 2020 Aug 1;113(8):573-574
pubmed: 32442268
N Engl J Med. 2020 May 14;382(20):e60
pubmed: 32343504
Acta Neurol Belg. 2020 Oct;120(5):1257-1258
pubmed: 32638268
Eur J Neurol. 2020 Sep;27(9):e35-e36
pubmed: 32352618