Acta Scientific Neurology (ASNE) (ISSN: 2582-1121)

Case Report Volume 4 Issue 7

Covid19-9 Infection Induced Hydrocephaly: A Case Report and Review the Article

Amir Kamalifar1*, Firooz Salehpour2, Farhad Mirzaii2, Samar Kamalifar3 and Ebrahim Rafeei2

1Department of Neurosurgery, Urumia University of Medical Sciences, Urumia, Iran
2Department of Neurosurgery, Tabriz University of Medical Sciences, Tabriz, Iran
3Student Research Committee, Arak University of Medical Sciences, Arak, Iran

*Corresponding Author: Amir Kamalifar, Department of Neurosurgery, Urumia University of Medical Sciences, Urumia, Iran.

Received: June 02, 2021; Published: June 29, 2021

Abstract

Covid19-9 can be presented with various neurological problem like headache, dizziness, anosmia…and sometimes was make disaster situation like intracranial hemorrhage. We report 32 years old woman with post covid19-9 infected late onset hydrocephaly.

Keywords: COVID19-9; Hydrocephaly; Altered Conscious

What is “already known “in this article

Covid19-9 infection can induce neurological problem like headache dizziness,…and this sign an symptom can be complicated the patients situation.

What is the article add

One of covid19-9 infection sign can be hydrocephaly which was life treating and need emergency work up.

Introduction

  Covid19-9 as a pandemic infection nearly infected more than 130 million individuals and manifested with various sign and symptom [1], breathing system major part was involved but in period of pandemic many article released about the other organs infection with various sign and symptom. Anosmia was popular sign of CNS manifestation during of infection, but headache, dizziness, impaired consciousness, acute cerebrovascular disease, epilepsy also can be seen in infected patients [2,3]. Some symptom like headache and dizziness can be worsen in patient with sever covid19-9 infection, due to respiratory failure or hypoxia [4]. Altered conscious level was reported in elderly patients who infected severely, cerebrovascular accident like hemorrhagic or thrombotic stroke was reported maybe due to intrinsic coagulation and anti-coagulation imbalance [5], in other hand dysfunction of ACE-2 receptor in cerebral arterial endothelial cell during cov19-9 infection can’t be ignored [6], Acute necrotizing encephalopathy (ANE) and encephalitis with cov19-9 was also reported in literature [7], in this article we present 32 years old woman with sever hydrocephaly due to post covid19-9 infection.

Case Presentation

  A32 years old women admitted to hospital with headache and confusion and vomiting from last night, in initial assessment vital sign was normal (BT=36.4.RR=13,BP=100/70,PR:81), she was confused and bilateral papilledema significant finding, nuchal rigidity and kernik and brodensky was negative, blood sample analyzed (See table), patient go under brain non contrast spiral computed tomography (CT) significant ventriculomegaly and periventricular edema without any mass lesion was reported, for future evaluation lumbar puncture was done in lateral decubitus position CSF pressure 23 cm H2o and CSF sample analyzed for biochemical compound and cell count and cytology (Table), patient go under emergency brain MRI without contrast, significant ventriculomegally and periventricular edema without any mass lesion or occupying lesion, in past medical history last month she be quarantine in home because of positive covid19-9 PCR test, and passed 14 days in home with acetaminophen 500 mg/q8h, past drug history was negative, patient go under close external ventricular drainage (EVD), after 8 hours she extubated, conscious level was normal without any vomiting episode, we also analyzed CSF sample for TB PCR test and HSV-1, CSF culture was done for aerobe, anaerobe infection and fungal at least for 1 week in 3 sample. Brain MRI with contrast and brain MRA, MRV also done every evaluation was negative to infection and occupying lesion to can refereed the hydrocephaly, after one week we change the EVD catheter with ventriculoperitoneal shunt and patient discharge in healthy state.

Figure 1:
Line 1: Coronal T1 MRI without contrast show ventriculomegally in lateral ventricle.
Line 2: Sagittal and axial T2 MRI show dilation of lateral ventricle and wi9dening of temporal horn.
Line 3: Axial flair MRI show dilation of lateral ventricle with periventricular edema.

Blood sample item

Result

WBC

5000-7000

Hb

13.1MG/DL

Plt

275000

BS

105mg/dl

CRP

6

ESR

5

Na

143

K

4.1

Table 1: Blood sample analysis.

CSF item

Result

Glucose

67mg/dl

Protein

46mg/dl

WBC

Negative

RBC

Negative

Cytology

Negative for malignancy

VDRL

Negative

Culture

Negative after 6 days incubation

TB(PCR)

Negative

Table 2: CSF sample analysis.

Discussion

  Covid19-9 infection word –wild concern which affected all individuals. SARS-COV-2 infection known with acute respiratory failure and fever in last 16 month researcher try to declare other system infection problem, CNS sign and symptom manifestation wide varied from headache to ANE and hemorrhage, scientist guess CNS involvement can be direct or indirect infection [6,7]. Disruption of BBB through release of cytokine and invading of cerebral tissue and manifested by encephalitis in addition hypoxia and immune system mediated nerve injury other theory, recently ACE-2 receptor more favorable molecule in study of covid19-9 pathogenesis, ACE-2 receptor usually found in arterial wall cells and regulate arterial pressure, spike protein of covid19-9 can interact with ACE-2 receptor and induced blood pressure and arterial disruption specially in fine vessels [8], in other hand Jacomi., et al. declared the covid19-9can invade to brain stem neural cell and damage cardio-respiratory regulation center which can make severe respiratory failure and hypoxia [9], we report acute hydrocephaly in 32 years old women due to covid19-9 infection, maybe our patient have arrested hydrocephaly which decompensated with cerebrit of virus other theory it was direct infection of arachnoid villi can decrease absorption of CSF and hydrocephaly be presented this sentences just theoretical, maybe not true and need to future study.

Conclusion

  During of covid19-9 infection physician should be alter about the wide spectrum neurological sign and symptom of infected patient. And consecutive neurological examination in survived can be helpful to find late onset neurological problem.

Compliance with Ethical Guideline

All steps of this article reviewed by Tabriz university of medical science ethical committee, ethical code ir-tmsu.rec1399.4325/7654.

Acknowledgment

We really appreciate fooziyeh samadi for reviewing this article.

Conflict of Interest

The author declare that they have no competing interest.

References

  1. Bai Y., et al. “Presumed asymptomatic carrier transmission of COVID-19”. JAMA 323 (2020): 1406.
  2. Wang Yixuan., et al. “Unique epidemiological and clinical features of the emerging 2019 novel coronavirus pneumonia (COVID‐19) implicate special control measures”. Journal of Medical Virology6 (2020): 568-576.
  3. Zou L., et al. “SARS-CoV-2 viral load in upper respiratory specimens of infected patients”. The New England Journal of Medicine 382 (2020): 1177-1179.
  4. Hwang CS. “Olfactory neuropathy in severe acute respiratory syndrome: report of A case”. Acta Neurologica Taiwanica1 (2006): 26-29.
  5. Cummings MJ., et al. “Epidemiology, clinical course, and outcomes of critically ill adults with COVID-19 in New York City: a prospective cohort study”. Lancet 10239 (2020): 1763-1770.
  6. Liguori C., et al. “Subjective neurological symptoms frequently occur in patients with SARS-CoV2 infection”. Brain, Behavior, and Immunity 88 (2020): 11-16.
  7. McFadyen JD., et al. “The Emerging threat of (Micro)thrombosis in COVID-19 and its therapeutic implications”. Circulation Research4 (2020): 571-587.
  8. Lau KK., et al. “Possible central nervous system infection by SARS coronavirus”. Emerging Infectious Diseases 2 (2004): 342-344.
  9. Jacomy H and Talbot PJ. “Vacuolating encephalitis in mice infected by human coronavirus OC43”. Virology 1 (2003): 20-33.

Citation

Citation: Amir Kamalifar., et al. “Covid19-9 Infection Induced Hydrocephaly: A Case Report and Review the Article”. Acta Scientific Neurology 4.7 (2021): 75-77.

Copyright

Copyright: © 2021 Amir Kamalifar., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




Metrics

Acceptance rate32%
Acceptance to publication20-30 days

Indexed In




News and Events


  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is April 30th, 2024.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of "Best Article of the Issue"
  • Welcoming Article Submission
    Acta Scientific delightfully welcomes active researchers for submission of articles towards the upcoming issue of respective journals.

Contact US