COVID-19-associated spontaneous subacute subdural haematoma: report of two cases

Since March 2020, the pandemic of coronavirus disease 2019 (COVID-19) has become a threat to global health. Several kinds of coronavirus-associated disorders, including vascular involvements with neurological symptoms, have been reported worldwide. Here, we describe two individuals with COVID-19 with no history of traumatic brain injury nor of vascular injuries, who developed spontaneous subdural haematoma in a subacute process. Both individuals became lethargic and unresponsive during admission in the intensive care unit. Both have undergone emergent craniotomy with acceptable outcome. The first patient improved significantly and was discharged a week after surgery. However, the second individual had no improvement on her consciousness and died 3 days after surgery. Haemorrhagic events, including subdural haematoma, can happen during COVID-19 infection with several possible mechanisms. Brain imaging and further neurological evaluation must be performed in any individuals with COVID-19 who show signs of alteration in their state of consciousness.