Stroke in COVID-19 and Pregnancy: A Case Report

Gama, Mylana Dandara Pereira; Júnior, José Ronaldo Lessa Angelo; Correia, Carolina da Cunha

doi:10.1590/0037-8682-0301-2021

Cited by 7 publications

(15 citation statements)

References 12 publications

(24 reference statements)

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“… 26 The women diagnosed with ischemic stroke also presented focal seizures; the brain image revealed an extensive infarct with a hemorrhagic component and a possible lesion in the related arterial trunk. 25 The brain image of the other case also presented an infarct associated with extensive venous thrombosis, and she went on to develop increased intracranial pressure. 26 …”

Section: Resultsmentioning

confidence: 95%

“…Finally, we reviewed 18 case reports from the selected 17 papers (Tables 1 and 2 ). 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 …”

Section: Resultsmentioning

confidence: 99%

“…Central nervous system involvement was reported in nine cases 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 (Table 1 ): delirium 20 ( n = 1); posterior reversible encephalopathy syndrome 21 , 22 , 23 , 24 (PRES) ( n = 4); cerebrovascular disease 25 , 26 (CVD) ( n = 2), one case of arterial involvement and one of venous; acute cerebral demyelinating disease 27 (ADEM) ( n = 1); and acute necrotizing encephalopathy 28 (ANE) ( n = 1).…”

Section: Resultsmentioning

confidence: 99%

“…Both women with cerebrovascular disease presented with headaches and signs of focal brain lesions, including, in both cases, unilateral motor signs, 25 , 26 hemianopsia, 25 or aphasia. 26 The women diagnosed with ischemic stroke also presented focal seizures; the brain image revealed an extensive infarct with a hemorrhagic component and a possible lesion in the related arterial trunk.…”

Section: Resultsmentioning

confidence: 99%

“…36 SARS-CoV-2 has a high affinity for ACE2 receptors expressed by endothelial cells and arterial smooth muscle cells throughout the body, including the brain. 25,36 Inflammation, platelet activation, endothelial dysfunction, and blood flow stasis associated with COVID-19 predispose patients to thrombotic events, mainly associated with the transient prothrombotic state of pregnancy and puerperal period. 26 The binding of SARS-CoV-2 to ACE2 also impairs the conversion of angiotensin II, which has vasoconstrictive and proinflammatory effects.…”

Section: Mechanismsmentioning

confidence: 99%

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Pregnancy and neurologic complications of COVID‐19: A scoping review

Magalhães

Rocha-Filho

2022

Acta Neuro Scandinavica

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While neurologic complications are frequently reported among patients with COVID‐19 in the general population, they are unknown in pregnant women. This paper summarizes the case reports of pregnant women with confirmed SARS‐CoV‐2 infection plus a specified neurologic diagnosis. Until November 2021, 18 case reports were found. Both the central and peripheral nervous systems were equally affected: delirium ( n = 1), posterior reversible encephalopathy syndrome ( n = 4), cerebrovascular disease ( n = 2), acute cerebral demyelinating disease ( n = 1), acute necrotizing encephalopathy ( n = 1), Guillain–Barré syndrome ( n = 5), including one patient who also had vestibular neuritis, Bell's palsy ( n = 3), and rhabdomyolysis ( n = 1). The median maternal age was 32.5 (25—35) years, the median gestational age was 34 (30—36.5) weeks, and 38.9% presented previous medical conditions. Respiratory symptoms were reported in 76.5%, and 76.5% received immunotherapies to treat the COVID‐19 or the neurologic complications. Half the women required admission to ICU and, more often, were those with central nervous system involvement (77.8% vs. 22.2%; Chi‐square test, p = .018). For 64.7% of women, the most common method of delivery was surgical, although just one case was due to the neurologic complication. There were reports of one spontaneous abortion, two fetal deaths, and no maternal deaths. Only one case presented a poor neurologic outcome. It is possible that our findings are underestimated, considering that there are thousands of reports regarding neurologic complications in the general population with COVID‐19.

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Section: Resultsmentioning

confidence: 95%

“…Finally, we reviewed 18 case reports from the selected 17 papers (Tables 1 and 2 ). 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 …”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Mechanismsmentioning

confidence: 99%

See 3 more Smart Citations

Pregnancy and neurologic complications of COVID‐19: A scoping review

Magalhães

Rocha-Filho

2022

Acta Neuro Scandinavica

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COVID-19 Headache During Pregnancy and Breastfeeding

Domaç

2023

Headache Disorders in Pandemic Conditions

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Stroke in Pregnancy and Puerperium - Current Knowledge, Questions and Controversies

Pavlović¹

2023

Arch. Psychiatry Res.

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Stroke associated with pregnancy and the postpartum period (SiPP) is not common but its consequences can be devastating both for the mother and the child. Pregnancy confers a substantially increased risk of stroke, especially during the third trimester and until 6 weeks postpartum. SiPP is heterogeneous both in aetiology and presentation as it includes both ischemic and haemorrhagic events as well as cerebral venous thrombosis. Specific risk factors for SiPP have been identified and well described, such as hypertensive disorders of pregnancy and a prothrombotic state. However, it is still a controversial issue if pregnancy should be considered a risk factor for stroke, although pregnancy and postpartum period clearly increase the stroke risk compared to non-pregnant time. Recent European Stroke Organization [ESO] guidelines addressed the management of acute SiPP while other issues, particularly primary and secondary prevention are still under investigated. There is also a lack of research and knowledge regarding long-term mother and foetus/child outcomes post-SiPP. This paper addresses current knowledge on SiPP management and prognosis and discusses new challenging clinical scenarios including the relationship between COVID-19 infection and SiPP.

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Stroke in COVID-19 and Pregnancy: A Case Report

Cited by 7 publications

References 12 publications

Pregnancy and neurologic complications of COVID‐19: A scoping review

Pregnancy and neurologic complications of COVID‐19: A scoping review

COVID-19 Headache During Pregnancy and Breastfeeding

Stroke in Pregnancy and Puerperium - Current Knowledge, Questions and Controversies

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