COVID-19 Infection Presenting With Severe Hydrocephalus and Acute Stroke: A Case Report

Oredipe, Omotola; Johal, Anmol S; Onuegbu, Chinwendu; Kalejaiye, Ayoola; Okoye, Chiugo; Pozdniakova, Helen; Udongwo, Ndausung; Patel, Swapnil

doi:10.7759/cureus.30592

Cited by 2 publications

(4 citation statements)

References 12 publications

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“…To our knowledge there are no other cases reported in the literature of an NPH worsening shortly before the evidence of SARS-CoV-2 infection. Other authors reported cases of patients with “delayed” development of NPH after COVID-19 (one week three months from infection), requiring surgery for the treatment of the hydrocephalus [ 11 - 13 ]. All these patients did not have other risk factors for NPH or significant medical history apart from a recent SARS-CoV-2 infection.…”

Section: Discussionmentioning

confidence: 99%

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Hydrocephalus As Possible Prodromal Manifestation of COVID-19: A Report of Two Cases

Torelli¹,

Severino²,

Caggiano³

et al. 2023

Cureus

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Although the etiopathology of normal pressure hydrocephalus (NPH) is still not completely defined, several studies in recent years have highlighted the role of neuro-inflammation mediators in its development.During COVID-19, the infected host develops a multifaceted inflammatory syndrome, that may lead to an uncontrolled immune system response also localized in the host nervous system. In fact, the target of the viral Spike protein, the angiotensin-converting enzyme 2 (ACE2) receptors, is widely expressed in different areas of CNS such as the olfactory epithelium, and the choroid plexus. As for idiopathic NPH, the massive release of inflammatory mediators may result in altered CSF dynamics and consequent sudden clinical decompensation.We report the cases of two patients with a known iNPH condition, in which neurological symptoms suddenly worsened, requiring hospitalization, without any evident precipitating cause. Both patients tested positive for the COVID-19 virus shortly after the neurological impairment, which had occurred, therefore, during the incubation period of the infection.On the basis of our experience we advise, in cases of NPH patients with sudden neurological worsening, to perform a molecular COVID-19 swab at the moment of clinical impairment. We, therefore, recommend considering SARS-CoV-2 infection in the differential diagnosis of a sudden and otherwise unexplainable impairment of hydrocephalic patients. Furthermore, we believe clinicians should invite NPH patients to adopt adequate preventive measures to protect them from SARS-CoV-2 infection.

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Section: Discussionmentioning

confidence: 99%

“…Since the beginning of the SARS-CoV-2 pandemic only three cases of previously healthy patients who developed NPH after COVID-19 infection have been described [11][12][13], suggesting that NPH may have been a complication of the neuro-inflammation response triggered by SARS-CoV2 in the nervous system.…”

Section: Introductionmentioning

confidence: 99%

Hydrocephalus As Possible Prodromal Manifestation of COVID-19: A Report of Two Cases

Torelli¹,

Severino²,

Caggiano³

et al. 2023

Cureus

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“…Literature review yielded six studies, four case reports [10][11][12][13] and two case series [14,15] iNPH: idiopatic normal pressure hydrocephalus; ADHD: attention-deficit/hyperactivity disorder According to our review, hydrocephalus onset during or after COVID-19 infection shows in adults an equal distribution among genders (five female, four male) and ages (age interval: 20-79). In almost half of the identified cases, the diagnosis of hydrocephalus was made concomitantly with the diagnosis of COVID-19 infection.…”

Section: Table 1: Studies Included In the Systematic Reviewmentioning

confidence: 97%

“…Two studies [8,9] were removed after reading the full text, because, although they met inclusion criteria, the reported hydrocephalus was to refer to acute SAH. Thus, a total of six articles [10][11][12][13][14][15] were included.…”

Section: Figure 3: Preferred Reporting Items For Systematic Reviews A...mentioning

confidence: 99%

Hydrocephalus as Possible Neurological Complication of COVID-19: A Case Report and Systematic Literature Review

Verrienti¹,

Megliola²,

Colamaria³

et al. 2023

Cureus

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Coronavirus disease 2019 , caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), typically affects the respiratory system but can also present with neurological manifestations. Although some cases of hydrocephalus related to COVID-19 infection have been reported, a clear association between these two entities is not universally recognized yet.Here, we report another interesting case of hydrocephalus in a 60-year-old man with a previous aneurysmal subarachnoid haemorrhage (aSAH) who tested positive for COVID-19. Secondly, we illustrate a systematic overview of the previously reported cases of hydrocephalus related to COVID-19 infection. Finally, in light of the literature, we discuss the supposed underlying mechanisms that could make the association between COVID-19 infection and hydrocephalus plausible.

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COVID-19 Infection Presenting With Severe Hydrocephalus and Acute Stroke: A Case Report

Cited by 2 publications

References 12 publications

Hydrocephalus As Possible Prodromal Manifestation of COVID-19: A Report of Two Cases

Hydrocephalus As Possible Prodromal Manifestation of COVID-19: A Report of Two Cases

Hydrocephalus as Possible Neurological Complication of COVID-19: A Case Report and Systematic Literature Review

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