NYMC Faculty Publications

Cerebral Herniation Secondary to Stroke-Associated Hemorrhagic Transformation, Fulminant Cerebral Edema in Setting of COVID-19 Associated ARDS and Active Malignancy

DOI

10.1016/j.jstrokecerebrovasdis.2020.105397

Journal Title

Journal of Stroke and Cerebrovascular Diseases

First Page

105397

Last Page

105397

Document Type

Case Report

Publication Date

12-1-2020

Department

Neurosurgery

Abstract

SARS-CoV-2 infection has been associated with ischemic stroke as well as systemic complications such as acute respiratory failure; cytotoxic edema is a well-known sequelae of acute ischemic stroke and can be worsened by the presence of hypercarbia induced by respiratory failure. We present the case of a very rapid neurologic and radiographic decline of a patient with an acute ischemic stroke who developed rapid fulminant cerebral edema leading to herniation in the setting of hypercarbic respiratory failure attributed to SARS-CoV-2 infection. Given the elevated incidence of cerebrovascular complications in patients with COVID-19, it is imperative for clinicians to be aware of the risk of rapidly progressive cerebral edema in patients who develop COVID-19 associated acute respiratory distress syndrome.

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