Ischemic Stroke and Subarachnoid Hemorrhage following Epstein-Barr Virus Infection

Rios, J. B. Magalhaes; Félix, Catarina; Proença, Paula; Malaia, L T; Nzwalo, Hipólito

doi:10.1055/s-0040-1717827

Cited by 2 publications

(1 citation statement)

References 7 publications

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“…Numerous reports of viral infections and nonaneurysmal SAH have been associated with COVID-19 caused by SARS-CoV-2,[ 1 - 4 , 6 , 7 , 9 , 12 , 16 , 17 , 23 , 24 ] while some have been associated with other viruses including human immunodeficiency virus, herpes simplex virus, Epstein–Barr virus, Jamestown Canyon virus, and varicella zoster virus. [ 10 , 15 , 21 , 25 - 27 ] Interestingly, there have been no reports of nonaneurysmal SAH caused by coronaviruses other than SARS-CoV-2, such as severe acute respiratory syndrome coronavirus 1 (SARS-CoV-1 or simply SARS-CoV) and Middle East respiratory syndrome coronavirus. As such, the true affinity of SARS-CoV-2 with cerebral vessels remains unknown in spite of an increasing number of reported cases.…”

Section: Discussionmentioning

confidence: 99%

Nonaneurysmal subarachnoid hemorrhage associated with COVID-19 infection: A case report

Kajita

Yanaka

Akimoto

et al. 2022

Surgical Neurology International

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Background: Most coronavirus disease 2019 (COVID-19)-related cerebrovascular disorders are ischemic while hemorrhagic disorders are rarely reported. Among these, subarachnoid hemorrhage (SAH) is very rarely reported and nonaneurysmal SAH has been reported in only about a dozen cases. Here, we report a case of nonaneurysmal SAH as the only clinical manifestation of COVID-19 infection. In addition, we reviewed and analyzed the literature data on cases of nonaneurysmal SAH caused by COVID-19 infection. Case Description: A 50-year-old woman presented to an emergency department with a sudden headache, right hemiparesis, and consciousness disturbance. At that time, no fever or respiratory failure was observed. Laboratory data were within normal values but the rapid antigen test for COVID-19 on admission was positive, resulting in a diagnosis of COVID-19 infection. Computed tomograms (CTs) showed bilateral convexal SAH with a hematoma but three-dimensional CT angiograms showed no obvious sources, such as a cerebral aneurysm. Therefore, the patient was diagnosed with nonaneurysmal SAH associated with COVID-19 infection. With conservative treatment, consciousness level and hemiparesis both improved gradually until transfer for continued rehabilitation. Approximately 12 weeks after onset, the patient was discharged with only mild cognitive impairment. During the entire course of the disease, the headache, hemiparesis, and mild cognitive impairment due to nonaneurysmal SAH with small hematoma were the only abnormalities experienced. Conclusion: Since COVID-19 infection can cause nonaneurysmal hemorrhaging, it should be considered (even in the absence of characteristic infectious or respiratory symptoms of COVID-19) when atypical hemorrhage distribution is seen as in our case.

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Section: Discussionmentioning

confidence: 99%

Nonaneurysmal subarachnoid hemorrhage associated with COVID-19 infection: A case report

Kajita

Yanaka

Akimoto

et al. 2022

Surgical Neurology International

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Viral Infection and Ischemic Stroke: Emerging Trends and Mechanistic Insights

Clarke,

Falcione,

Boghozian

et al. 2024

JAHA

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Population studies have suggested that viral infections may be contributing to risk of ischemic stroke, although the mechanisms for this are unclear. In this review, we examine the epidemiological evidence supporting the involvement of viral diseases, including influenza, COVID‐19, chronic herpesvirus infections, and hepatitis C in current trends of stroke incidence. To support these associations, we highlight the virus–host interactions that are critical in the context of stroke, including direct effects of acute and persistent viral infections on vascular function, inflammation, and thrombosis. Additionally, we evaluate the systemic changes that occur during viral infection that can predispose individuals to ischemic stroke, including alterations in blood pressure regulation, coagulation, and lipid metabolism. Our review emphasizes the need to further elucidate precise mechanisms involved in viral infections and stroke risk. Future research will inform the development of targeted interventions for stroke prevention in the context of viral diseases.

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Ischemic Stroke and Subarachnoid Hemorrhage following Epstein-Barr Virus Infection

Cited by 2 publications

References 7 publications

Nonaneurysmal subarachnoid hemorrhage associated with COVID-19 infection: A case report

Nonaneurysmal subarachnoid hemorrhage associated with COVID-19 infection: A case report

Viral Infection and Ischemic Stroke: Emerging Trends and Mechanistic Insights

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