Aneurysmal Subarachnoid Hemorrhage in Patients with Coronavirus Disease 2019 (COVID-19): A Case Series

William S. Dodd, Pascal M. Jabbour, Ahmad Sweid, Stavropoula Tjoumakaris, Michael R. Gooch, Fadi Al Saiegh, David M. Hasan, Robert M. Starke, Peter T. Kan, Adam J. Polifka, Dimitri Laurent, Katharina M. Busl, Ritam Ghosh, Brian L. Hoh, Nohra Chalouhi

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Objective: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic is a pressing public health issue. Although most cases do not result in severe illness requiring hospitalization, there is increasing evidence that SARS-CoV-2–induced inflammation can exacerbate pre-existing diseases. We sought to describe the characteristics of patients with aneurysmal subarachnoid hemorrhage who were actively or very recently infected with SARS-CoV-2. Methods: We reviewed subarachnoid hemorrhage cases of patients who also were positive for SARS-CoV-2 at 5 high-volume cerebrovascular centers in the United States from March 2020 to January 2021. Cases of aneurysmal subarachnoid hemorrhage were analyzed. Results: A total of 10 patients were identified, consisting of 5 women (50%) and 5 men (50%). Median age was 38.5 years. Four of the 10 patients (40%) were asymptomatic with respect to SARS-CoV-2–related symptoms, 3 patients (30%) had mild-to-moderate symptoms, and 3 patients (30%) had severe coronavirus disease 2019 (COVID-19), with pneumonia and sepsis. Of the 10 cases, 4 had dissecting pseudoaneurysms (40%), 3 in the posterior circulation and 1 in the anterior circulation. Among 6 saccular/blister aneurysms, 4 (67%) were ≤4 mm in largest diameter. Conclusions: Our experience with aneurysmal subarachnoid hemorrhage in patients positive for COVID-19 reveals a possibly distinct pattern compared with traditional aneurysmal subarachnoid hemorrhage, namely a high frequency of small aneurysms, dissecting pseudoaneurysms, and young patients.

Original languageEnglish (US)
Pages (from-to)e259-e264
JournalWorld neurosurgery
Volume153
DOIs
StatePublished - Sep 2021

Keywords

  • COVID-19
  • Cerebral aneurysm
  • SARS-CoV-2
  • Stroke
  • Subarachnoid hemorrhage

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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