Transcranial Doppler Ultrasound Evidence of Active Cerebral Embolization in COVID-19.
Transcranial Doppler Ultrasound Evidence of Active Cerebral Embolization in COVID-19.
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DOI：
10.1016/j.jstrokecerebrovasdis.2020.105542
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发表时间：
2021-03
期刊：
影响因子：
--
通讯作者：
Liotta EM
中科院分区：
文献类型：
--
作者：
Batra A;Clark JR;LaHaye K;Shlobin NA;Hoffman SC;Orban ZS;Colton K;Dematte JE;Sorond FA;Koralnik IJ;Liotta EM
报告6例连续确诊的冠状病毒病-2019 （COVID-19）患者，在怀疑或确诊急性缺血性卒中的情况下，接受经颅多普勒（TCD）超声检查脑微栓子。患者数据来自2020年5月至6月期间伊利诺伊州芝加哥西北纪念医院的医疗记录。所有确诊的COVID-19患者均接受临床TCD超声检测微栓子。共有6例COVID-19患者（4男2女，中位年龄65±5岁）进行了8项TCD研究，其中4例确诊为缺血性卒中，2例确诊为难治性脑病。在三名男性患者中检测到微栓子，其中两名患者确诊为缺血性中风，另一名患者发展为长期脑病。在两名患者中，在多个血管区域发现了不同强度的微栓子，而在第三名患者中，尽管进行了抗凝治疗，微栓子仍然存在。在TCD超声检查未发现微栓子的3例患者中，2例患者确诊为缺血性脑卒中，1例患者仍患有难治性脑病。TCD超声微栓子检测发现3例新冠肺炎确诊患者存在脑动脉微栓子证据，其中1例接受了抗凝治疗。TCD超声为评估COVID-19患者脑微栓子提供了一种无创方法，可用于评估疑似或确诊高凝性疾病患者的治疗效果。需要进一步研究脑微栓子的患病率及其相关危险因素，以表征其致病机制并指导住院患者的治疗干预。
To report six consecutive patients with confirmed coronavirus disease-2019 (COVID-19) who underwent Transcranial Doppler (TCD) ultrasonography evaluation for cerebral microemboli in the setting of suspected or confirmed acute ischemic stroke. Patient data were obtained from medical records from Northwestern Memorial Hospital, Chicago, IL between May and June 2020. All patients with confirmed COVID-19 who underwent clinical TCD ultrasonography for microemboli detection were included. A total of eight TCD studies were performed in six patients with COVID-19 (4 men and 2 women, median age 65±5), four with confirmed ischemic stroke and two with refractory encephalopathy. Microemboli were detected in three male patients, two patients had suffered a confirmed ischemic stroke and one who developed prolonged encephalopathy. Microemboli of varying intensity were identified in multiple vascular territories in two patients, and microemboli persisted despite therapeutic anticoagulation in a third patient. Of the three patients without evidence of microemboli on TCD ultrasonography, two patients had suffered a confirmed ischemic stroke, while one remained with refractory encephalopathy. TCD ultrasonography for microemboli detection identified three patients with confirmed COVID-19 with evidence of cerebral arterial microemboli, including one who was therapeutically anticoagulated. TCD ultrasonography provides a non-invasive method for evaluating cerebral microemboli in patients with COVID-19 and may be useful in assessing response to treatment in cases with suspected or confirmed disorders of hypercoagulability. Further studies investigating the prevalence of cerebral microemboli and associated risk factors are needed to characterize their pathogenic mechanism and guide therapeutic interventions in hospitalized COVID-19 patients.
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影响因子：
8.3
作者：
Sheriff, Faheem;Diz-Lopes, Mariana;Castro, Pedro
通讯作者：
Castro, Pedro
影响因子：
5.1
作者：
Baracchini, C.;Pieroni, A.;Malojcic, B.
通讯作者：
Malojcic, B.
影响因子：
48
作者：
Markus, Hugh S.;King, Alice;Shipley, Martin;Topakian, Raffi;Cullinane, Marisa;Reihill, Sheila;Bornstein, Natan M.;Schaafsma, Arjen
通讯作者：
Schaafsma, Arjen
影响因子：
5.3
作者：
Liotta EM;Batra A;Clark JR;Shlobin NA;Hoffman SC;Orban ZS;Koralnik IJ
通讯作者：
Koralnik IJ
影响因子：
2.7
作者：
Purkayastha S;Sorond F
通讯作者：
Sorond F