Background Coronavirus disease 2019 (COVID-19) pandemic has started in December 2019 and still ongoing. The disease has been expanding rapidly with a high variety of phenotypes from asymptomatic, mild respiratory tract infection, multiple organ system dysfunction, and death. Neurological manifestations also appear in patients with COVID-19, such as headache, seizures, a decrease of consciousness, and paralysis. The hypercoagulable state in patients with COVID-19 is associated with the thromboembolic incident including ischemic strokes, venous thromboembolism, pulmonary artery embolism, and many further. Cerebral sinus venous thrombosis (CSVT) is a rare neurovascular emergency that is often found in critically ill patients. We report two cases of CSVT with different onsets, neurologic manifestations, and prognoses. Case presentation Two cases of cerebral sinus venous thrombosis in COVID-19 patients were reported, following respiratory, hematology, and coagulation disarrangements, which was triggered by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The first patient, which was presented with a seizure, had hypertension and diabetes mellitus as comorbidities. The latter case had no comorbidity but showed more severe presentations of COVID-19 such as brain and lung thrombosis, although already had several days of intravenous anticoagulant administrations. These two cases also have a different course of disease and outcomes, which were interesting topics to study. Conclusions CSVT is one of the neurological complications of the COVID-19 when the brainstem venous drainage is involved. Despite successful alteration to the negative result of SARS-CoV-2 through the rt-PCR test, thrombogenesis and coagulation cascade continuing. Therefore, a high level of neutrophil to lymphocyte ratio (NLR), D-dimer, fibrinogen, and C-reactive protein (CRP) are paramount indicators of poor prognosis.

Stroke is one of the leading causes of death and disability which involving a complex pathophysiology with multiple mechanisms. Rapid treatment is necessary to terminate the disease progression, hence minimizing CNS damage and subsequent disability. Stroke diagnostic process composed of history taking, neurological examination and supplemented with neuroimaging. Imaging modalities such as CT-scan or MRI are essential in establishing a definitive diagnosis of ischemic stroke. However, the high cost and limited number made them inaccessible for those who have low or middle income which will delay the diagnosis and treatment. On the other hand, blood biomarker has potential in either diagnostic or prognostic aspect of ischaemic stroke management. It has a promising potential to aid diagnosis, determine the subtype of stroke, predicting the outcome or early neurological deterioration, and recurrence. It also could potentially help to assess the risk of hemorrhagic transformation, treatment selection, as well as to detect salvageable ischemic penumbra. Although it could not replace neuroimaging, blood-based biomarker assessment had lower cost and faster result. However, despite its promising potential, none of the blood biomarkers is currently used in clinical practice. Therefore, further studies are needed to develop biomarkers or panels of biomarkers with better sensitivity and specificity. This review provides a highlight and summary of blood biomarkers based on their potential application in a clinical setting.

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Background Guillain–Barre syndrome (GBS) is a complication that occurs in patients with Coronavirus Disease (COVID-19) infection. The spectrum of symptoms varies from mild to severe symptoms, even death. The study aimed to compare the clinical manifestations in GBS patients with and without COVID-19 comorbidity. Results A systematic review and meta-analysis of cohort and cross-sectional studies was conducted comparing the characteristics and course of GBS disease in the COVID-19 positive and COVID-19 negative groups. Four articles were selected with a total sample of 61 COVID-19 positive and 110 COVID-19 negative GBS patients. Based on clinical manifestations, COVID-19 infection increased the likelihood of tetraparesis (OR: 2.54; 95% CI 1.12–5.74; p = 0.03) and the presence of facial nerve involvement (OR: 2.34; 95% CI 1.00–5.47; p = 0.05). Demyelinating type GBS or AIDP was more common in the COVID-19 positive group (OR: 2.32; 95% CI 1.16–4.61; p = 0.02). COVID-19 in GBS significantly increased the need for intensive care (OR: 3.32; 95% CI 1.48–7.46; p = 0.004) and the use of mechanical ventilation (OR: 2.42; 95% CI 1.00–5.86; p = 0.05). Conclusions GBS following COVID-19 infection showed more severe variations in clinical characteristics compared to the group of GBS patients without COVID-19. Early detection of GBS, especially the typical manifestations post COVID-19 infection, is very important to carry out intensive monitoring and early management before the patient's condition worsens.

Latar Belakang: Pandemi Corona Virus Disease 2019 (COVID-19) dengan penularannya yang sangat cepat di seluruh dunia berdampak terhadap perubahan pelayanan kesehatan di bidang neurologi sebagai upaya mendukung program pengendalian penyakit ini. Tujuan: Merumuskan rekomendasi panduan pemeriksaan neurologis untuk pelayanan teleneurologi.   Diskusi: Penyesuaian dalam pelaksanaan pelayanan neurologi perlu segera dilakukan dengan mengadopsi metode pelayanan dengan telemedicine terutama dalam tata cara pemeriksaan pasien dengan pembatasan fisik dan sosial sebagai salah satu langkah pencegahan infeksi SARS-CoV-2. Simpulan: Layanan teleneurologi perlu dikembangkan dalam pelayanan neurologi termasuk pengembangan prosedur pemeriksaan neurologis secara virtual.