In December 2019, the first cases of atypical pneumonia caused by a new pathogen, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), were detected in Wuhan, China. In March 2020, the World Health Organization declared coronavirus disease-2019 (COVID-19) as a pandemic. 1,2 Manifestations within the respiratory system are dominant in COVID-19. However, other manifestations such as headache, abdominal pain, diarrhea, and loss of taste and smell have been added to the clinical spectrum during the course of the disease, 1,2 and numerous case series and reviews have been published on the neurological manifestations, highlighting the potential neurotropism of the new coronavirus. 3-5 Approximately 40% of patients with COVID-19 have presented with neurological symptoms. 3,4 Headache was reported in 11%-34% of the hospitalized patients, but few studies have carried out a characterization of pain. 5 An observational Spanish study described 112 health professionals who suffered headache during COVID-19. The authors found that headache appeared on the fourth day from the beginning of
Background: Prealbumin is a marker of malnutrition and inflammation. It has been associated with poor prognosis in cardiovascular disease, but less is known in stroke patients. Our objective was to evaluate the association of prealbumin levels at admission with prognosis in patients with stroke treated with mechanical thrombectomy. Material & Methods: Retrospective study of a prospective database of consecutive patients treated with mechanical thrombectomy. Clinical, radiological and blood parameters including serum prealbumin, and prognostic variables such as respiratory infection, in-hospital mortality, and modified Rankin scale at 3 months were collected. Results: We included 319 patients between 2018-2019. Prealbumin levels were significantly lower in patients older than 80 years, women, patients with a prestroke Rankin score >2, glomerular filtrate rate <60 ml/min and in those with atrial fibrillation. Regarding prognostic variables, prealbumin levels were not associated with respiratory infection. Low prealbumin levels were associated with poor functional prognosis (Rankin score >2), in-hospital mortality and 3-month mortality. In multivariate analysis, prealbumin was an independent risk factor associated with mortality at 3 months, OR 0.92 [0.86-0.98], p = 0.019. Conclusion: Lower prealbumin levels at admission behaved as independent predictor of long-term mortality in patients treated with mechanical thrombectomy. These results should be replicated in other cohorts.
Hereditary angio-oedema with C1 inhibitor deficiency (C1-INH-HAE) type I is a rare immune disorder characterised by a deficit of functional C1 esterase inhibitor (C1-INH). Recurrent C1-INH-HAE attacks typically present as generalised skin swelling and abdominal pain. Neurological involvement is very unusual, with a few reports of cephalea and recurrent dizziness. We describe a woman in her 30s diagnosed with C1-INH-HAE type I who was referred to the emergency department suffering from left hemisensory syndrome, with the initial suspicion of an ischaemic stroke. A few hours after hospital admission, she presented an acute attack of facial swelling and abdominal pain, receiving intravenous C1-INH concentrate with complete resolution of all symptoms, including neurological ones. A complete aetiological study ruled out a stroke. We pointed out that C1-INH-HAE attack can be an unusual stroke mimic that responds favourably to replacement therapy.
This case report describes an 80-year-old patient’s right-sided hemicranial headache, right-sided tongue hemiatrophy with fasciculations and deviation, right side of the tongue on protrusion, and mild dysarthria.
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