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Case Reports
. 2020 Aug 20;383(8):764-773.
doi: 10.1056/NEJMcpc2004976.

Case 26-2020: A 60-Year-Old Woman with Altered Mental Status and Weakness on the Left Side

Aneesh B Singhal  1 , R Gilberto Gonzalez  1 , Bart K Chwalisz  1 , Shibani S Mukerji  1
Affiliations
Case Reports

Case 26-2020: A 60-Year-Old Woman with Altered Mental Status and Weakness on the Left Side

Aneesh B Singhal et al. N Engl J Med. .
No abstract available

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Figures

Figure 1
Figure 1. Imaging Studies of the Head and Chest.
MRI was performed 2 hours after presentation. A diffusion-weighted image (Panel A) shows a punctate focus of restricted diffusion within the posterior limb of the right internal capsule (arrow). No corresponding abnormality is observed on a T2-weighted fluid-attenuated inversion recovery image (Panel B). A chest radiograph (Panel C) obtained 2.5 hours after presentation shows a nodular focus in the left midlung field (arrow).
Figure 2
Figure 2. Stroke Subtypes and Mechanisms in SARS-CoV-2 Infection.
Coagulopathy and inflammation (black box) are central to thrombosis within cerebral blood vessels and cardiac embolism, the two major mechanisms of ischemic stroke in SARS-CoV-2 infection. Other possible mechanisms of stroke and sources of cardiac embolism are listed in the lighter boxes. Patients with SARS-CoV-2 infection may have a higher risk of stroke because of coexisting factors such as advanced age, cardiovascular disease, nonadherence to medications, and cerebral microvascular dysfunction. ACE2 denotes angiotensin-converting enzyme 2, and RAAS renin–angiotensin–aldosterone system.
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