Abstract

Background:SARS-CoV can cause dysfunction of multiple organs and systems. Cardiovascular complications after COVID-19 have now been reported very often but the knowledge of neurovascular complications especially Intracerebral hemorrhage is undetermined.

Aim of the study: To describe the natural history of acute Intracranial Hemorrhage (ICH) in COVID-19 patients.

Patients and Methods:

A case series study was performed at Al-Imamain Al-Kadhimain medical city and Saad Alwitry Hospital for Neuroscience in 2021.

Result: Twenty patients with ICH were included in this study, 12 (60%) participants were males while females were 8 (40%) participants with mean age of 54.38±10.51 years; 10 (50%) patients had high systolic & diastolic blood pressure on presentation with preexisted hypertension and /or diabetes. The most prevalent comorbidities were Hypertension and Diabetes mellitus. The maximum duration between initial infection and presentation of ICH was 30 days in both males and females ranging between 5 and 30 days. Regarding the site of involvement (50%) of patients presented with cerebral hemisphere (deep-seated ) involvement on CT scan and 3 (15%) of deep-seated developed intraventricular extension and 3 (15%) had lobar presentation. Cerebellar, brainstem, and SAH were the least site of presentation with 10%, 5%, and 5%, respectively. According to lab investigation. 13 out of 20 patients (70%) in the present series had positive PCR with variable IgM and IgG results, but almost all of them had abnormal D-dimer, CRP, and S. ferritin with mean 1208, 27, 453 respectively. Almost all of the patients had normal Hb and platelet levels, with a mean of abnormal neutrophil (77) 109/L, and (16) 109/L lymphocyte count.

Conclusion: This study provides evidence of ICH in the middle-aged patients demographic, a deep-seated predominance, and a marked systemic inflammatory prodrome. SARS-Covid-19 increases the preexistence risk such as HTN, DM, and the ICH cannot be attributed solely to COVID-19 itself.