Characteristics of Large-Vessel Occlusion Associated with COVID-19 and Ischemic Stroke.

Autor:	John S; Department of Neurology (S.J., P.K., V.A.M., B.P.-J., S.I.H.), Neurological Institute johns5@clevelandclinicabudhabi.ae.; Neurointerventional Surgery (S.J., M.S.E., K.Z.)., Kesav P; Department of Neurology (S.J., P.K., V.A.M., B.P.-J., S.I.H.), Neurological Institute., Mifsud VA; Department of Neurology (S.J., P.K., V.A.M., B.P.-J., S.I.H.), Neurological Institute., Piechowski-Jozwiak B; Department of Neurology (S.J., P.K., V.A.M., B.P.-J., S.I.H.), Neurological Institute., Dibu J; Neurocritical Care Unit (J.D., A.B., H.E.), Critical Care Institute., Bayrlee A; Neurocritical Care Unit (J.D., A.B., H.E.), Critical Care Institute., Elkambergy H; Neurocritical Care Unit (J.D., A.B., H.E.), Critical Care Institute., Roser F; Department of Neurosurgery, Neurological Institute (F.R., M.S.E.), Cleveland Clinic, Abu Dhabi, United Arab Emirates., Elhammady MS; Neurointerventional Surgery (S.J., M.S.E., K.Z.).; Department of Neurosurgery, Neurological Institute (F.R., M.S.E.), Cleveland Clinic, Abu Dhabi, United Arab Emirates., Zahra K; Neurointerventional Surgery (S.J., M.S.E., K.Z.)., Hussain SI; Department of Neurology (S.J., P.K., V.A.M., B.P.-J., S.I.H.), Neurological Institute.
Jazyk:	angličtina
Zdroj:	AJNR. American journal of neuroradiology [AJNR Am J Neuroradiol] 2020 Dec; Vol. 41 (12), pp. 2263-2268. Date of Electronic Publication: 2020 Aug 27.
DOI:	10.3174/ajnr.A6799
Abstrakt:	The mechanisms and phenotype of ischemic stroke associated with coronavirus disease 2019 (COVID-19) remain uncertain. A retrospective study was conducted in patients with COVID-19 presenting with ischemic stroke from March 1 to May 25, 2020, and cases with large-vessel occlusion were identified. To provide baseline institutional stroke data within and outside the COVID-19 pandemic, all consecutive ischemic stroke and TIA admissions (COVID and non-COVID) to the hospital during a 10-week period from March 1 to May 10, 2020, were collected and compared with data from the same time period in 2019. Among 20 patients with COVID-19 and acute ischemic stroke, 15 (75%) had large-vessel occlusion. These patients were young (mean age, 46.5 years), male (93%), without major burden of traditional cardiovascular risk factors, and had a severe stroke presentation. Large-vessel occlusions were observed in multiple vessels (40%), uncommonly affected vessels, and atypical locations with a large thrombus burden. Systemic thrombosis separate from large-vessel occlusion was not uncommon (26%). At short-term follow-up, stroke etiology remained undetermined in 46% of patients and functional outcome was poor. The above findings raise the possibility of stroke related to mechanisms induced by the COVID-19 infection itself, including a hypercoagulable state and/or endothelial damage. In addition, they document the severe presentation and poor outcomes of large-vessel occlusion in COVID-19 ischemic stroke. (© 2020 by American Journal of Neuroradiology.)
Databáze:	MEDLINE
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