Early recanalization and vasospasm after endovascular treatment in a case of ruptured vertebral artery dissecting aneurysm associated with COVID-19

• Published in: Surgical neurology international Vol. 14; p. 324
• Main Authors: Nakamura, Yukihiko, Takashima, Chihiro, Nonaka, Takahisa, Ohkubo, Taku, Kawano, Takayuki, Okura, Akira, Kondou, Daisuke, Sonoda, Kazutaka, Hirohata, Masaru, Morioka, Motohiro
• Format: Journal Article
• Language: English
• Published: USA Scientific Scholar 08.09.2023
• Subjects: Case Report
• ISSN: 2229-5097; 2152-7806
• DOI: 10.25259/SNI_517_2023

Background: The coronavirus disease 2019 (COVID-19) pandemic has caused significant structural changes in acute care hospitals. COVID-19-associated stroke has gained attention, with abnormal coagulation and vascular endothelial damage being recognized. While ischemic cases are commonly reported, hemorrhagic cases have also been reported. This report presents a case of ruptured vertebral artery dissection aneurysm associated with COVID-19, resulting in subarachnoid hemorrhage (SAH). The treatment course, challenges in managing cerebral vasospasm, and early recanalization achieved through endovascular therapy are described. Case Description: A 67-year-old male patient was brought to our hospital for emergency treatment of impaired consciousness that occurred while recovering from COVID-19. He underwent endovascular internal trapping using coils, and although the rupture did not recur, he required long-term tracheal management, which resulted in a cerebral infarction caused by cerebral vasospasm. In addition, early recanalization was seen, which required retreatment. Conclusion: This case highlights the challenges in managing COVID-19-associated SAH and emphasizes the need for infection control measures and proper postoperative care. Establishing protocols for detecting and managing cerebral vasospasm is essential.