Ritwik Ghosh1, Dipayan Roy2,3,4, Adrija Ray5, Amrita Mandal6, Shambaditya Das7, Shyamal Kanti Pal1, Julián Benito-León8,9,10. 1. Department of General Medicine, Burdwan Medical College & Hospital, Burdwan, West Bengal, India. 2. Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan, India. 3. Indian Institute of Technology (IIT), Madras, Tamil Nadu, India. 4. School of Humanities, Indira Gandhi National Open University, New Delhi, India. 5. Department of Medicine, RG Kar Medical College and Hospital, Kolkata, West Bengal, India. 6. Bankura Sammilani Medical College and Hospital, Bankura, West Bengal, India. 7. Department of Neuromedicine, Bangur Institute of Neurosciences (BIN), Kolkata, West Bengal, India. 8. Department of Neurology, University Hospital "12 de Octubre", Madrid, Spain. 9. Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain. 10. Department of Medicine, Complutense University, Madrid, Spain.
Abstract
BACKGROUND: Hemorrhagic cerebrovascular events, either due to aneurysmal rupture or spontaneous subarachnoid hemorrhage (SAH), are not rare in COVID-19. Several mechanisms such as coagulopathy, cytokine storm, viral endotheliopathy, hypertension, and immune modulation might play a role in the pathogenesis of SAH in COVID-19. This study aimed to report the first case of spontaneous non-aneurysmal SAH associated with SARS-CoV-2 from India. We briefly discussed the possible pathogenetic mechanisms underlying this process and succinctly reviewed the relevant literature. CASE REPORT: We herein report a case of a non-comorbid young woman infected with SARS-CoV-2 presenting with thunderclap headache and eventually non-aneurysmal SAH, who recovered with conservative management. CONCLUSION: Headache, although a very common clinical feature of COVID-19 itself, must be investigated in detail to identify alternate causes that may be life-threatening. This case also incites further enquiry into the possible pathogenic mechanisms of neurovascular complications in COVID-19.
BACKGROUND: Hemorrhagic cerebrovascular events, either due to aneurysmal rupture or spontaneous subarachnoid hemorrhage (SAH), are not rare in COVID-19. Several mechanisms such as coagulopathy, cytokine storm, viral endotheliopathy, hypertension, and immune modulation might play a role in the pathogenesis of SAH in COVID-19. This study aimed to report the first case of spontaneous non-aneurysmal SAH associated with SARS-CoV-2 from India. We briefly discussed the possible pathogenetic mechanisms underlying this process and succinctly reviewed the relevant literature. CASE REPORT: We herein report a case of a non-comorbid young woman infected with SARS-CoV-2 presenting with thunderclap headache and eventually non-aneurysmal SAH, who recovered with conservative management. CONCLUSION: Headache, although a very common clinical feature of COVID-19 itself, must be investigated in detail to identify alternate causes that may be life-threatening. This case also incites further enquiry into the possible pathogenic mechanisms of neurovascular complications in COVID-19.
Authors: Lennie Lynn C de Castillo; Jose Danilo B Diestro; Katrina Hannah D Ignacio; Karl Josef Niño J Separa; Paul Matthew D Pasco; Maria Carissa P Franks Journal: Can J Neurol Sci Date: 2020-11-05 Impact factor: 2.104