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Case Reports
. 2023 Jun;4(2):65-68.
doi: 10.1016/j.hest.2022.08.002. Epub 2022 Aug 12.

Intracerebral hemorrhage associated COVID-19 patient with normal coagulation profile after ECMO treatment: A case report

Wael Osman Amer  1   2 , Hussein Awad El Gharieb  1   3 , Hossam Ibrahim  4 , Ahmed Alanazi  5 , Mostafa Meshref  1
Affiliations
Case Reports

Intracerebral hemorrhage associated COVID-19 patient with normal coagulation profile after ECMO treatment: A case report

Wael Osman Amer et al. Brain Hemorrhages. 2023 Jun.

Abstract

Objective: Coronavirus disease 2019 (COVID-19) is a novel coronavirus-caused infectious acute respiratory disease that can progress to severe acute respiratory distress syndrome (ARDS). For severe cases, extracorporeal membrane oxygenation (ECMO) is an excellent treatment option. ECMO had a number of side effects, including bleeding. Intracerebral hemorrhage can occur in COVID patients due to a variety of mechanisms, including covid's effect on ACE-2 receptors and subsequent hypertension, coagulopathy, DIC, or medication, such as anticoagulant use.

Case presentation: We present a case of a 53-year-old male COVID-19 patient who developed multiple, massive, severe intracerebral hemorrhages (ICH) despite a normal coagulation profile after ECMO treatment.

Conclusion: COVID-19 can progress to severe acute respiratory distress syndrome (ARDS), necessitating the use of extracorporeal membrane oxygenation (ECMO). Although ICH is not a common complication in patients with COVID-19 disease, it is unknown why this patient had a lower threshold of ICH despite having a normal coagulation profile.

Keywords: Coagulation profile; Coronavirus; Extracorporeal membrane oxygenation (ECMO); ICH.

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Figures

Fig. 1
Fig. 1
CT brain which showed ICH progression over admission days.
Fig. 2
Fig. 2
Last follow up CT brain which showed massive multiple ICH with increased ventricular compression, increased IVH, increased SAH and increased the inferior displacement of the cerebellar tonsils (herniation).
See this image and copyright information in PMC

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