tetano
Editor, Senior Moderator
BMC Neurol
. 2024 Jan 2;24(1):17.
doi: 10.1186/s12883-023-03493-z. Persistent intracranial hyper-inflammation in ruptured cerebral aneurysm after COVID-19: case report and review of the literature
Pin Fee Chong[SUP] 1 [/SUP], Kanako Higashi[SUP] 1 2 [/SUP], Wakato Matsuoka[SUP] 1 2 [/SUP], Koichi Arimura[SUP] 3 [/SUP], Yuhei Sangatsuda[SUP] 3 [/SUP], Katsuma Iwaki[SUP] 3 [/SUP], Yuri Sonoda[SUP] 1 4 [/SUP], Yuko Ichimiya[SUP] 1 [/SUP], Akiko Kamori[SUP] 1 [/SUP], Akiko Kawakami[SUP] 1 2 [/SUP], Soichi Mizuguchi[SUP] 1 2 [/SUP], Noriyuki Kaku[SUP] 1 2 [/SUP], Yasunari Sakai[SUP] 5 [/SUP], Shouichi Ohga[SUP] 1 [/SUP]
Affiliations
Background: The systemic manifestations of coronavirus disease 2019 (COVID-19) include hyperinflammatory reactions in various organs. Recent studies showed evidence for the frequent involvement of central nervous system in affected patients; however, little is known about clinical features of cerebrovascular diseases in childhood-onset COVID-19.
Case presentation: A 10-year-old boy recovered from SARS-CoV-2 infection without complication. On 14 days after infection, he presented with loss of consciousness. A head computed tomography detected a ruptured cerebral aneurysm at the left posterior cerebral artery accompanying subarachnoid hemorrhage (SAH). Immediate surgical intervention did not rescue the patient, resulting in the demise 7 days after admission. Serological and genetic tests excluded the diagnosis of vasculitis and connective tissue disorders. Retrospective analysis showed markedly higher levels of interleukin (IL)-1β, IL-6 and IL-8 in the cerebrospinal fluid than the serum sample concurrently obtained. A review of literature indicated that adult patients with COVID-19 have a risk for the later development of SAH during the convalescent phase of COVID-19.
Conclusions: SAH is a severe complication of COVID-19 in children and adults who have asymptomatic cerebrovascular aneurysms. The markedly high levels of cytokines detected in the cerebrospinal fluid suggested that intracranial hyperinflammatory condition might be one of the possible mechanisms involved in the rupture of a preexisting cerebrovascular aneurysms.
Keywords: Cerebral aneurysm; IL-6; Posterior cerebral artery; SARS-CoV-2; Subarachnoid hemorrhage.
. 2024 Jan 2;24(1):17.
doi: 10.1186/s12883-023-03493-z. Persistent intracranial hyper-inflammation in ruptured cerebral aneurysm after COVID-19: case report and review of the literature
Pin Fee Chong[SUP] 1 [/SUP], Kanako Higashi[SUP] 1 2 [/SUP], Wakato Matsuoka[SUP] 1 2 [/SUP], Koichi Arimura[SUP] 3 [/SUP], Yuhei Sangatsuda[SUP] 3 [/SUP], Katsuma Iwaki[SUP] 3 [/SUP], Yuri Sonoda[SUP] 1 4 [/SUP], Yuko Ichimiya[SUP] 1 [/SUP], Akiko Kamori[SUP] 1 [/SUP], Akiko Kawakami[SUP] 1 2 [/SUP], Soichi Mizuguchi[SUP] 1 2 [/SUP], Noriyuki Kaku[SUP] 1 2 [/SUP], Yasunari Sakai[SUP] 5 [/SUP], Shouichi Ohga[SUP] 1 [/SUP]
Affiliations
- PMID: 38166683
- DOI: 10.1186/s12883-023-03493-z
Background: The systemic manifestations of coronavirus disease 2019 (COVID-19) include hyperinflammatory reactions in various organs. Recent studies showed evidence for the frequent involvement of central nervous system in affected patients; however, little is known about clinical features of cerebrovascular diseases in childhood-onset COVID-19.
Case presentation: A 10-year-old boy recovered from SARS-CoV-2 infection without complication. On 14 days after infection, he presented with loss of consciousness. A head computed tomography detected a ruptured cerebral aneurysm at the left posterior cerebral artery accompanying subarachnoid hemorrhage (SAH). Immediate surgical intervention did not rescue the patient, resulting in the demise 7 days after admission. Serological and genetic tests excluded the diagnosis of vasculitis and connective tissue disorders. Retrospective analysis showed markedly higher levels of interleukin (IL)-1β, IL-6 and IL-8 in the cerebrospinal fluid than the serum sample concurrently obtained. A review of literature indicated that adult patients with COVID-19 have a risk for the later development of SAH during the convalescent phase of COVID-19.
Conclusions: SAH is a severe complication of COVID-19 in children and adults who have asymptomatic cerebrovascular aneurysms. The markedly high levels of cytokines detected in the cerebrospinal fluid suggested that intracranial hyperinflammatory condition might be one of the possible mechanisms involved in the rupture of a preexisting cerebrovascular aneurysms.
Keywords: Cerebral aneurysm; IL-6; Posterior cerebral artery; SARS-CoV-2; Subarachnoid hemorrhage.