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Locked-In with COVID-19

Coronavirus Disease 2019 (COVID-19) can be associated with various neurological manifestations including acute strokes. Hyper acute diagnosis and treatment are key factors which decrease mortality and morbidity in stroke patients. The COVID-19 pandemic has introduced a great strain on the healthcare...

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Autores principales: Avula, Akshay, Gill, Arshpal, Nassar, Ra'ed, Nalleballe, Krishna, Siddamreddy, Suman, Chalhoub, Michel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier Ltd. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7351413/
https://www.ncbi.nlm.nih.gov/pubmed/33070924
http://dx.doi.org/10.1016/j.jocn.2020.07.014
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author Avula, Akshay
Gill, Arshpal
Nassar, Ra'ed
Nalleballe, Krishna
Siddamreddy, Suman
Chalhoub, Michel
author_facet Avula, Akshay
Gill, Arshpal
Nassar, Ra'ed
Nalleballe, Krishna
Siddamreddy, Suman
Chalhoub, Michel
author_sort Avula, Akshay
collection PubMed
description Coronavirus Disease 2019 (COVID-19) can be associated with various neurological manifestations including acute strokes. Hyper acute diagnosis and treatment are key factors which decrease mortality and morbidity in stroke patients. The COVID-19 pandemic has introduced a great strain on the healthcare system, and as a result clinicians are facing several barriers in diagnosing and treating strokes. Delayed presentation of strokes is a problem as some in the general population defer the decision to seek immediate medical attention fearing contracting the virus. Also playing a role is the paucity of healthcare professionals available during a pandemic. Recent literature demonstrates the association of acute strokes in young patients with COVID-19. Lack of clear pathophysiology of the neurological manifestations from COVID-19 intensifies the problem. A thorough examination of the intensive care unit patient has always been a challenge owing to several factors including use of sedatives, sepsis, uremia, and encephalopathy secondary to medications. Locked-In Syndrome (LIS) secondary to stroke is much more challenging to diagnose as patients are unable to communicate or elicit any motor functions apart from certain ocular movements. We present the case of a 25 year old patient with no known history of coagulopathy, but had developed COVID-19 cytokine storm which culminated in LIS secondary to pontine strokes.
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spelling pubmed-73514132020-07-13 Locked-In with COVID-19 Avula, Akshay Gill, Arshpal Nassar, Ra'ed Nalleballe, Krishna Siddamreddy, Suman Chalhoub, Michel J Clin Neurosci Case Report Coronavirus Disease 2019 (COVID-19) can be associated with various neurological manifestations including acute strokes. Hyper acute diagnosis and treatment are key factors which decrease mortality and morbidity in stroke patients. The COVID-19 pandemic has introduced a great strain on the healthcare system, and as a result clinicians are facing several barriers in diagnosing and treating strokes. Delayed presentation of strokes is a problem as some in the general population defer the decision to seek immediate medical attention fearing contracting the virus. Also playing a role is the paucity of healthcare professionals available during a pandemic. Recent literature demonstrates the association of acute strokes in young patients with COVID-19. Lack of clear pathophysiology of the neurological manifestations from COVID-19 intensifies the problem. A thorough examination of the intensive care unit patient has always been a challenge owing to several factors including use of sedatives, sepsis, uremia, and encephalopathy secondary to medications. Locked-In Syndrome (LIS) secondary to stroke is much more challenging to diagnose as patients are unable to communicate or elicit any motor functions apart from certain ocular movements. We present the case of a 25 year old patient with no known history of coagulopathy, but had developed COVID-19 cytokine storm which culminated in LIS secondary to pontine strokes. Elsevier Ltd. 2020-09 2020-07-10 /pmc/articles/PMC7351413/ /pubmed/33070924 http://dx.doi.org/10.1016/j.jocn.2020.07.014 Text en © 2020 Elsevier Ltd. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Case Report
Avula, Akshay
Gill, Arshpal
Nassar, Ra'ed
Nalleballe, Krishna
Siddamreddy, Suman
Chalhoub, Michel
Locked-In with COVID-19
title Locked-In with COVID-19
title_full Locked-In with COVID-19
title_fullStr Locked-In with COVID-19
title_full_unstemmed Locked-In with COVID-19
title_short Locked-In with COVID-19
title_sort locked-in with covid-19
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7351413/
https://www.ncbi.nlm.nih.gov/pubmed/33070924
http://dx.doi.org/10.1016/j.jocn.2020.07.014
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