Stroke Treatment in the Era of COVID-19: a Review

Simonetto, Marialaura; Wechsler, Paul M; Merkler, Alexander E

doi:10.1007/s11940-022-00713-8

Cited by 12 publications

(36 citation statements)

References 103 publications

(89 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Stroke in COVID-19 is often severe with higher presenting NIHSS. In one study, the presenting NIH stroke scale was often severe (average range: [19][20][21], with up to one quarter of patients also having systemic thromboses (splenic, pulmonary, and other venous emboli also present). 7 LVOs appear to occur more frequently than in historical controls, and are more likely to have clot fragmentation, multiterritory involvement, and uncommon stroke locations such as higher prevalence of vertebrobasilar territory strokes.…”

Section: Stroke Characteristics With Covid-19mentioning

confidence: 99%

“…However, no change should be made in decisions regarding administration of thrombolytics based on laboratory results which are not typically used for decision-making. 19 45 46…”

Section: Ischemic Strokementioning

confidence: 99%

“…However, the risk with COVID-19 appears to be much greater with up to a sevenfold increase in stroke risk with COVID-19 versus influenza. 18,19 The duration of increased stroke risk is unknown but appears highest in the first weeks following acute infection. In a Swedish case series, the incident rate ratio for AIS was 6.8 in the first week, but dropped to 2.14 for weeks 3 to 4.…”

Section: Incidence and Epidemiologymentioning

confidence: 99%

“…However, no change should be made in decisions regarding administration of thrombolytics based on laboratory results which are not typically used for decision-making. 19,45,46 Mechanical thrombectomy for LVOs remains an appropriate treatment using standard inclusion criteria (imaging, time last seen well) with the addition of appropriate personal protective equipment in place for all persons within the angiography suite. 47 Patients requiring general anesthesia for the procedure should be intubated in a negative pressure room, and rapid intubation protocols should be initiated to prevent delay to reperfusion.…”

Section: Management Considerations For Ais Associated With Sars-cov-2mentioning

confidence: 99%

See 3 more Smart Citations

COVID-19 and Cerebrovascular Disease

Catherine,

Veitinger,

Chou

2023

Semin Neurol

View full text Add to dashboard Cite

COVID-19 has been associated with numerous neurological complications, with acute cerebrovascular disease being one of the most devastating complications. Ischemic stroke is the most common cerebrovascular complication of COVID-19, affecting between 1 and 6% of all patients. Underlying mechanisms for COVID-related ischemic strokes are thought to be due to vasculopathy, endotheliopathy, direct invasion of the arterial wall, and platelet activation. Other COVID-19-associated cerebrovascular complications include hemorrhagic stroke, cerebral microbleeds, posterior reversible encephalopathy syndrome, reversible cerebral vasoconstriction syndrome, cerebral venous sinus thrombosis, and subarachnoid hemorrhage. This article discusses the incidence of these cerebrovascular complications, risk factors, management strategies, prognosis and future research directions, as well as considerations in pregnancy-related cerebrovascular events in the setting of COVID-19.

show abstract

Section: Stroke Characteristics With Covid-19mentioning

confidence: 99%

“…However, no change should be made in decisions regarding administration of thrombolytics based on laboratory results which are not typically used for decision-making. 19 45 46…”

Section: Ischemic Strokementioning

confidence: 99%

Section: Incidence and Epidemiologymentioning

confidence: 99%

Section: Management Considerations For Ais Associated With Sars-cov-2mentioning

confidence: 99%

See 2 more Smart Citations

COVID-19 and Cerebrovascular Disease

Catherine,

Veitinger,

Chou

2023

Semin Neurol

View full text Add to dashboard Cite

show abstract

“…Disamping itu pasien COVID-19 dengan AIS LVO lebih banyak durasi rawat inap dan lebih tinggi angka kematian di rumah sakit. 10,11,12…”

Section: Metoda Penelitianunclassified

Tatalaksana Oklusi Pembuluh Darah Besar Pada Pasien Stroke Iskemik Akut Dengan Infeksi Covid-19 : Sebuah Review Narasi

Sephe¹

2022

JMI

View full text Add to dashboard Cite

Pendahuluan Keadaan hiperkoagulasi yang disebabkan oleh sindrom pernapasan akut berat karena infeksi coronavirus 2 (SARSCoV-2) menyebabkan peningkatan frekuensi terjadinya gangguan tromboemboli yang memicu terjadinya stroke iskemik akut karena oklusi pembuluh darah besar (AIS LVO) pada usia muda tanpa adanya faktor resiko/komorbid vaskular sebelumnya dengan angka kematian sebesar 44,2 % - 60%. Metode Kami melakukan pencarian literatur pada Pubmed dengan menggunakan kata kunci sebagai berikut stroke iskemik akut/AIS, oklusi pembuluh darah besar/LVO, Covid-19, SARS-CoV-2, trombektomi/MT dan tatalaksana stroke iskemik akut. Lalu meninjau literatur studi kohort observasional, studi kasus-kontrol, seri kasus, laporan kasus, tinjauan sistematis dan metanalisis yang diterbitkan antara Januari 2020 dan Mei 2022 yang menggambarkan tatalaksana pasien Covid-19 dengan AIS LVO. Artikel non-bahasa inggris tidak termasuk. Hasil Trombektomi mekanis adalah metode pengobatan invasif untuk AIS LVO yang menggunakan balon kateter yang dimasukkan ke dalam sistem arteri sehingga diperlukan Angiogram CT sebelum dilakukan pemindahan pasien ke pusat trombektomi untuk memastikan keberadaan LVO. Keberhasilan tindakan trombektomi mekanis dinilai dengan skor TICI 2b/3 yang menunjukan perfusi lengkap. Simpulan Infeksi Covid-19 memperburuk hasil klinis, meningkatkan resiko kematian dan dapat menimbulkan komplikasi berupa perdarahan intrakranial dan reoklusi arteri dini serta kekambuhan pada pasien AIS LVO pasca dilakukan trombektomi mekanis sehingga pemantauan berkala, deteksi cepat dan kepatuhan terhadap protokol pengendalian infeksi post MT sangatlah penting.

show abstract