A case of subarachnoid hemorrhage due to ruptured internal carotid artery dissecting aneurysm with concomitant COVID-19

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  • COVID-19に合併した破裂性内頚動脈解離によるくも膜下出血に対してclipping on wrappingを施行した1例

Abstract

<p>The occurrence of subarachnoid hemorrhage due to internal carotid artery dissection in patients with coronavirus disease 2019 (COVID-19) is rare. A 52-year-old man with impaired consciousness, who was infected with severe acute respiratory syndrome coronavirus-2 five days earlier, was referred to our hospital. Brain computed tomography (CT) and CT angiography revealed subarachnoid hemorrhage but did not show apparent aneurysm. Therefore, we performed external ventricular drainage and medical treatment for COVID-19. Dilatation in the C1 portion of the left internal carotid artery and small aneurysm gradually appeared in a time-series radiological imaging, and the patient was diagnosed with ruptured internal carotid artery dissecting aneurysm. Additionally, we performed clipping on wrapping on the 16th day of admission. He was transferred to a rehabilitation hospital with a modified Rankin Scale score of 4. Considering the pathology and COVID-19 infectious activity, it is important to determine the appropriate time for surgical treatment and strategy for ruptured dissecting cerebral aneurysm for each patient with COVID-19.</p>

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