tetano
Editor, Senior Moderator
Case Rep Neurol
. 2023 Feb 3;15(1):11-23.
doi: 10.1159/000529122. eCollection 2023 Jan-Dec.
COVID-19-Associated Cerebrovascular Events: A Case Series Study and a Literature Review of Possible Mechanisms
Mostafa Meshref[SUP] 1 [/SUP], Ibrahim M Hewila[SUP] 1 2 [/SUP], Yahia Khlidj[SUP] 3 [/SUP], Rafik Korissi[SUP] 3 [/SUP], Nour Shaheen[SUP] 4 [/SUP], Abdulqadir J Nashwan[SUP] 5 [/SUP], Yassamine Ouerdane[SUP] 6 [/SUP], Yara Amro[SUP] 7 [/SUP], Khaled M Taher[SUP] 8 [/SUP], Mahmoud Galal Ahmed[SUP] 1 [/SUP]
Affiliations
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) affects multiple body systems, including the nervous system. Cerebrovascular accidents can also occur. Patients with comorbid illnesses have severe manifestations and poor outcomes. Despite the proper mechanism of SARS-CoV-2 infection-associated stroke having not yet been settled, various possible mechanisms have been hypothesized. One possibility is that the virus causes endothelial dysfunction and immune-mediated injury. Another possibility is that the trans-neuronal spread of the virus affects brain tissue. In addition, hypercoagulability caused by SARS-CoV-2 infection could lead to a stroke. A virus-induced dysfunction of the renin-angiotensin system could also lead to a stroke. The immune response and vasculitis resulting from SARS-CoV-2 infection are also possible causes via a cytokine storm, immune dysfunction, and various inflammatory responses. SARS-CoV-2 infection may affect calcitonin gene-related peptides and cerebral blood flow and may lead to stroke. Finally, SARS-CoV-2 may cause hemorrhagic strokes via mechanisms stimulated by its interaction with angiotensin-converting enzyme 2 (ACE2), leading to arterial wall damage and blood pressure changes. In this article, we will present seven cases of stroke-associated SARS-CoV-2 infection.
Keywords: Cytokine storm; Hemorrhagic stroke; Immune dysfunction; Severe acute respiratory syndrome coronavirus 2; Stroke.
. 2023 Feb 3;15(1):11-23.
doi: 10.1159/000529122. eCollection 2023 Jan-Dec.
COVID-19-Associated Cerebrovascular Events: A Case Series Study and a Literature Review of Possible Mechanisms
Mostafa Meshref[SUP] 1 [/SUP], Ibrahim M Hewila[SUP] 1 2 [/SUP], Yahia Khlidj[SUP] 3 [/SUP], Rafik Korissi[SUP] 3 [/SUP], Nour Shaheen[SUP] 4 [/SUP], Abdulqadir J Nashwan[SUP] 5 [/SUP], Yassamine Ouerdane[SUP] 6 [/SUP], Yara Amro[SUP] 7 [/SUP], Khaled M Taher[SUP] 8 [/SUP], Mahmoud Galal Ahmed[SUP] 1 [/SUP]
Affiliations
- PMID: 36748059
- PMCID: PMC9898811
- DOI: 10.1159/000529122
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) affects multiple body systems, including the nervous system. Cerebrovascular accidents can also occur. Patients with comorbid illnesses have severe manifestations and poor outcomes. Despite the proper mechanism of SARS-CoV-2 infection-associated stroke having not yet been settled, various possible mechanisms have been hypothesized. One possibility is that the virus causes endothelial dysfunction and immune-mediated injury. Another possibility is that the trans-neuronal spread of the virus affects brain tissue. In addition, hypercoagulability caused by SARS-CoV-2 infection could lead to a stroke. A virus-induced dysfunction of the renin-angiotensin system could also lead to a stroke. The immune response and vasculitis resulting from SARS-CoV-2 infection are also possible causes via a cytokine storm, immune dysfunction, and various inflammatory responses. SARS-CoV-2 infection may affect calcitonin gene-related peptides and cerebral blood flow and may lead to stroke. Finally, SARS-CoV-2 may cause hemorrhagic strokes via mechanisms stimulated by its interaction with angiotensin-converting enzyme 2 (ACE2), leading to arterial wall damage and blood pressure changes. In this article, we will present seven cases of stroke-associated SARS-CoV-2 infection.
Keywords: Cytokine storm; Hemorrhagic stroke; Immune dysfunction; Severe acute respiratory syndrome coronavirus 2; Stroke.