Clinical and Imaging Characteristics in Patients with SARS-CoV-2 Infection and Acute Intracranial Hemorrhage.
Identifieur interne : 001340 ( Main/Exploration ); précédent : 001339; suivant : 001341Clinical and Imaging Characteristics in Patients with SARS-CoV-2 Infection and Acute Intracranial Hemorrhage.
Auteurs : Jawed Nawabi [Allemagne] ; Andrea Morotti [Italie] ; Moritz Wildgruber [Allemagne] ; Gregoire Boulouis [France] ; Hermann Kraehling [Allemagne] ; Frieder Schlunk [Allemagne] ; Elif Can [Allemagne] ; Helge Kniep [Allemagne] ; Götz Thomalla [Allemagne] ; Marios Psychogios [Suisse] ; Bernd Hamm [Allemagne] ; Jens Fiehler [Allemagne] ; Uta Hanning [Allemagne] ; Peter Sporns [Allemagne, Suisse]Source :
- Journal of clinical medicine [ 2077-0383 ] ; 2020.
Abstract
BACKGROUND AND PURPOSE
Intracranial hemorrhage has been observed in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (COVID-19), but the clinical, imaging, and pathophysiological features of intracranial bleeding during COVID-19 infection remain poorly characterized. This study describes clinical and imaging characteristics of patients with COVID-19 infection who presented with intracranial bleeding in a European multicenter cohort.
METHODS
This is a multicenter retrospective, observational case series including 18 consecutive patients with COVID-19 infection and intracranial hemorrhage. Data were collected from February to May 2020 at five designated European special care centers for COVID-19. The diagnosis of COVID-19 was based on laboratory-confirmed diagnosis of SARS-CoV-2. Intracranial bleeding was diagnosed on computed tomography (CT) of the brain within one month of the date of COVID-19 diagnosis. The clinical, laboratory, radiologic, and pathologic findings, therapy and outcomes in COVID-19 patients presenting with intracranial bleeding were analyzed.
RESULTS
Eighteen patients had evidence of acute intracranial bleeding within 11 days (IQR 9-29) of admission. Six patients had parenchymal hemorrhage (33.3%), 11 had subarachnoid hemorrhage (SAH) (61.1%), and one patient had subdural hemorrhage (5.6%). Three patients presented with intraventricular hemorrhage (IVH) (16.7%).
CONCLUSION
This study represents the largest case series of patients with intracranial hemorrhage diagnosed with COVID-19 based on key European countries with geospatial hotspots of SARS-CoV-2. Isolated SAH along the convexity may be a predominant bleeding manifestation and may occur in a late temporal course of severe COVID-19.
DOI: 10.3390/jcm9082543
PubMed: 32781623
PubMed Central: PMC7464657
Affiliations:
- Allemagne, France, Italie, Suisse
- Bavière, Berlin, District de Haute-Bavière, District de Münster, Hambourg, Rhénanie-du-Nord-Westphalie, Île-de-France
- Berlin, Hambourg, Munich, Münster, Paris
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type="city">Munich</settlement></placeName></affiliation></author><author><name sortKey="Boulouis, Gregoire" sort="Boulouis, Gregoire" uniqKey="Boulouis G" first="Gregoire" last="Boulouis">Gregoire Boulouis</name><affiliation wicri:level="3"><nlm:affiliation>Pediatric Radiology Department, Necker Enfants Malades & GHU Paris, Sainte-Anne Hospital, Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR S1266, INSERM, Université de Paris, 75015 Paris, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Pediatric Radiology Department, Necker Enfants Malades & GHU Paris, Sainte-Anne Hospital, Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR S1266, INSERM, Université de Paris, 75015 Paris</wicri:regionArea><placeName><region type="region" nuts="2">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Kraehling, Hermann" sort="Kraehling, Hermann" uniqKey="Kraehling H" first="Hermann" last="Kraehling">Hermann Kraehling</name><affiliation wicri:level="3"><nlm:affiliation>Department of Radiology, University Hospital Muenster, 48149 Muenster, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Radiology, University Hospital Muenster, 48149 Muenster</wicri:regionArea><placeName><region type="land" nuts="1">Rhénanie-du-Nord-Westphalie</region><region type="district" nuts="2">District de Münster</region><settlement type="city">Münster</settlement></placeName></affiliation></author><author><name sortKey="Schlunk, Frieder" sort="Schlunk, Frieder" uniqKey="Schlunk F" first="Frieder" last="Schlunk">Frieder Schlunk</name><affiliation wicri:level="3"><nlm:affiliation>Department of Neuroradiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 14195 Berlin, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Neuroradiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 14195 Berlin</wicri:regionArea><placeName><region type="land" nuts="3">Berlin</region><settlement type="city">Berlin</settlement></placeName></affiliation></author><author><name sortKey="Can, Elif" sort="Can, Elif" uniqKey="Can E" first="Elif" last="Can">Elif Can</name><affiliation wicri:level="3"><nlm:affiliation>Department of Radiology (CCM), Charité-Universitätsmedizin Berlin, Campus Mitte, Humboldt-Universität zu Berlin, Freie Universität Berlin, 14195 Berlin, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Radiology (CCM), Charité-Universitätsmedizin Berlin, Campus Mitte, Humboldt-Universität zu Berlin, Freie Universität Berlin, 14195 Berlin</wicri:regionArea><placeName><region type="land" nuts="3">Berlin</region><settlement type="city">Berlin</settlement></placeName></affiliation></author><author><name sortKey="Kniep, Helge" sort="Kniep, Helge" uniqKey="Kniep H" first="Helge" last="Kniep">Helge Kniep</name><affiliation wicri:level="1"><nlm:affiliation>Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg Eppendorf, 20251 Hamburg, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg Eppendorf, 20251 Hamburg</wicri:regionArea><wicri:noRegion>20251 Hamburg</wicri:noRegion><placeName><settlement type="city">Hambourg</settlement><region type="land" nuts="2">Hambourg</region></placeName></affiliation></author><author><name sortKey="Thomalla, Gotz" sort="Thomalla, Gotz" uniqKey="Thomalla G" first="Götz" last="Thomalla">Götz Thomalla</name><affiliation wicri:level="1"><nlm:affiliation>Department of Neurology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Neurology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg</wicri:regionArea><wicri:noRegion>20251 Hamburg</wicri:noRegion><placeName><settlement type="city">Hambourg</settlement><region type="land" nuts="2">Hambourg</region></placeName></affiliation></author><author><name sortKey="Psychogios, Marios" sort="Psychogios, Marios" uniqKey="Psychogios M" first="Marios" last="Psychogios">Marios Psychogios</name><affiliation wicri:level="1"><nlm:affiliation>Department of Neuroradiology, Clinic for Radiology and Nuclear Medicine, University Hospital Basel, 4031 Basel, Switzerland.</nlm:affiliation><country xml:lang="fr">Suisse</country><wicri:regionArea>Department of Neuroradiology, Clinic for Radiology and Nuclear Medicine, University Hospital Basel, 4031 Basel</wicri:regionArea><wicri:noRegion>4031 Basel</wicri:noRegion></affiliation></author><author><name sortKey="Hamm, Bernd" sort="Hamm, Bernd" uniqKey="Hamm B" first="Bernd" last="Hamm">Bernd Hamm</name><affiliation wicri:level="3"><nlm:affiliation>Department of Radiology (CCM), Charité-Universitätsmedizin Berlin, Campus Mitte, Humboldt-Universität zu Berlin, Freie Universität Berlin, 14195 Berlin, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Radiology (CCM), Charité-Universitätsmedizin Berlin, Campus Mitte, Humboldt-Universität zu Berlin, Freie Universität Berlin, 14195 Berlin</wicri:regionArea><placeName><region type="land" nuts="3">Berlin</region><settlement type="city">Berlin</settlement></placeName></affiliation></author><author><name sortKey="Fiehler, Jens" sort="Fiehler, Jens" uniqKey="Fiehler J" first="Jens" last="Fiehler">Jens Fiehler</name><affiliation wicri:level="1"><nlm:affiliation>Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg Eppendorf, 20251 Hamburg, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg Eppendorf, 20251 Hamburg</wicri:regionArea><wicri:noRegion>20251 Hamburg</wicri:noRegion><placeName><settlement type="city">Hambourg</settlement><region type="land" nuts="2">Hambourg</region></placeName></affiliation></author><author><name sortKey="Hanning, Uta" sort="Hanning, Uta" uniqKey="Hanning U" first="Uta" last="Hanning">Uta Hanning</name><affiliation wicri:level="1"><nlm:affiliation>Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg Eppendorf, 20251 Hamburg, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg Eppendorf, 20251 Hamburg</wicri:regionArea><wicri:noRegion>20251 Hamburg</wicri:noRegion><placeName><settlement type="city">Hambourg</settlement><region type="land" nuts="2">Hambourg</region></placeName></affiliation></author><author><name sortKey="Sporns, Peter" sort="Sporns, Peter" uniqKey="Sporns P" first="Peter" last="Sporns">Peter Sporns</name><affiliation wicri:level="1"><nlm:affiliation>Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg Eppendorf, 20251 Hamburg, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg Eppendorf, 20251 Hamburg</wicri:regionArea><wicri:noRegion>20251 Hamburg</wicri:noRegion><placeName><settlement type="city">Hambourg</settlement><region type="land" nuts="2">Hambourg</region></placeName></affiliation><affiliation wicri:level="1"><nlm:affiliation>Department of Neuroradiology, Clinic for Radiology and Nuclear Medicine, University Hospital Basel, 4031 Basel, Switzerland.</nlm:affiliation><country xml:lang="fr">Suisse</country><wicri:regionArea>Department of Neuroradiology, Clinic for Radiology and Nuclear Medicine, University Hospital Basel, 4031 Basel</wicri:regionArea><wicri:noRegion>4031 Basel</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2020">2020</date><idno type="RBID">pubmed:32781623</idno><idno type="pmid">32781623</idno><idno type="doi">10.3390/jcm9082543</idno><idno type="pmc">PMC7464657</idno><idno type="wicri:Area/Main/Corpus">000635</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000635</idno><idno type="wicri:Area/Main/Curation">000635</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Curation">000635</idno><idno type="wicri:Area/Main/Exploration">000635</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Clinical and Imaging Characteristics in Patients with SARS-CoV-2 Infection and Acute Intracranial Hemorrhage.</title><author><name sortKey="Nawabi, Jawed" sort="Nawabi, Jawed" uniqKey="Nawabi J" first="Jawed" last="Nawabi">Jawed Nawabi</name><affiliation wicri:level="3"><nlm:affiliation>Department of Radiology (CCM), Charité-Universitätsmedizin Berlin, Campus Mitte, Humboldt-Universität zu Berlin, Freie Universität Berlin, 14195 Berlin, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Radiology (CCM), Charité-Universitätsmedizin Berlin, Campus Mitte, Humboldt-Universität zu Berlin, Freie Universität Berlin, 14195 Berlin</wicri:regionArea><placeName><region type="land" nuts="3">Berlin</region><settlement type="city">Berlin</settlement></placeName></affiliation></author><author><name sortKey="Morotti, Andrea" sort="Morotti, Andrea" uniqKey="Morotti A" first="Andrea" last="Morotti">Andrea Morotti</name><affiliation wicri:level="1"><nlm:affiliation>Neurology Unit, ASST Valcamonica, Esine, 25040 Brescia, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Neurology Unit, ASST Valcamonica, Esine, 25040 Brescia</wicri:regionArea><wicri:noRegion>25040 Brescia</wicri:noRegion></affiliation></author><author><name sortKey="Wildgruber, Moritz" sort="Wildgruber, Moritz" uniqKey="Wildgruber M" first="Moritz" last="Wildgruber">Moritz Wildgruber</name><affiliation wicri:level="3"><nlm:affiliation>Klinik und Poliklinik für Radiologie, Klinikum der Universität (LMU), 81377 Munich, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Klinik und Poliklinik für Radiologie, Klinikum der Universität (LMU), 81377 Munich</wicri:regionArea><placeName><region type="land" nuts="1">Bavière</region><region type="district" nuts="2">District de Haute-Bavière</region><settlement type="city">Munich</settlement></placeName></affiliation></author><author><name sortKey="Boulouis, Gregoire" sort="Boulouis, Gregoire" uniqKey="Boulouis G" first="Gregoire" last="Boulouis">Gregoire Boulouis</name><affiliation wicri:level="3"><nlm:affiliation>Pediatric Radiology Department, Necker Enfants Malades & GHU Paris, Sainte-Anne Hospital, Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR S1266, INSERM, Université de Paris, 75015 Paris, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Pediatric Radiology Department, Necker Enfants Malades & GHU Paris, Sainte-Anne Hospital, Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR S1266, INSERM, Université de Paris, 75015 Paris</wicri:regionArea><placeName><region type="region" nuts="2">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Kraehling, Hermann" sort="Kraehling, Hermann" uniqKey="Kraehling H" first="Hermann" last="Kraehling">Hermann Kraehling</name><affiliation wicri:level="3"><nlm:affiliation>Department of Radiology, University Hospital Muenster, 48149 Muenster, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Radiology, University Hospital Muenster, 48149 Muenster</wicri:regionArea><placeName><region type="land" nuts="1">Rhénanie-du-Nord-Westphalie</region><region type="district" nuts="2">District de Münster</region><settlement type="city">Münster</settlement></placeName></affiliation></author><author><name sortKey="Schlunk, Frieder" sort="Schlunk, Frieder" uniqKey="Schlunk F" first="Frieder" last="Schlunk">Frieder Schlunk</name><affiliation wicri:level="3"><nlm:affiliation>Department of Neuroradiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 14195 Berlin, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Neuroradiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 14195 Berlin</wicri:regionArea><placeName><region type="land" nuts="3">Berlin</region><settlement type="city">Berlin</settlement></placeName></affiliation></author><author><name sortKey="Can, Elif" sort="Can, Elif" uniqKey="Can E" first="Elif" last="Can">Elif Can</name><affiliation wicri:level="3"><nlm:affiliation>Department of Radiology (CCM), Charité-Universitätsmedizin Berlin, Campus Mitte, Humboldt-Universität zu Berlin, Freie Universität Berlin, 14195 Berlin, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Radiology (CCM), Charité-Universitätsmedizin Berlin, Campus Mitte, Humboldt-Universität zu Berlin, Freie Universität Berlin, 14195 Berlin</wicri:regionArea><placeName><region type="land" nuts="3">Berlin</region><settlement type="city">Berlin</settlement></placeName></affiliation></author><author><name sortKey="Kniep, Helge" sort="Kniep, Helge" uniqKey="Kniep H" first="Helge" last="Kniep">Helge Kniep</name><affiliation wicri:level="1"><nlm:affiliation>Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg Eppendorf, 20251 Hamburg, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg Eppendorf, 20251 Hamburg</wicri:regionArea><wicri:noRegion>20251 Hamburg</wicri:noRegion><placeName><settlement type="city">Hambourg</settlement><region type="land" nuts="2">Hambourg</region></placeName></affiliation></author><author><name sortKey="Thomalla, Gotz" sort="Thomalla, Gotz" uniqKey="Thomalla G" first="Götz" last="Thomalla">Götz Thomalla</name><affiliation wicri:level="1"><nlm:affiliation>Department of Neurology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Neurology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg</wicri:regionArea><wicri:noRegion>20251 Hamburg</wicri:noRegion><placeName><settlement type="city">Hambourg</settlement><region type="land" nuts="2">Hambourg</region></placeName></affiliation></author><author><name sortKey="Psychogios, Marios" sort="Psychogios, Marios" uniqKey="Psychogios M" first="Marios" last="Psychogios">Marios Psychogios</name><affiliation wicri:level="1"><nlm:affiliation>Department of Neuroradiology, Clinic for Radiology and Nuclear Medicine, University Hospital Basel, 4031 Basel, Switzerland.</nlm:affiliation><country xml:lang="fr">Suisse</country><wicri:regionArea>Department of Neuroradiology, Clinic for Radiology and Nuclear Medicine, University Hospital Basel, 4031 Basel</wicri:regionArea><wicri:noRegion>4031 Basel</wicri:noRegion></affiliation></author><author><name sortKey="Hamm, Bernd" sort="Hamm, Bernd" uniqKey="Hamm B" first="Bernd" last="Hamm">Bernd Hamm</name><affiliation wicri:level="3"><nlm:affiliation>Department of Radiology (CCM), Charité-Universitätsmedizin Berlin, Campus Mitte, Humboldt-Universität zu Berlin, Freie Universität Berlin, 14195 Berlin, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Radiology (CCM), Charité-Universitätsmedizin Berlin, Campus Mitte, Humboldt-Universität zu Berlin, Freie Universität Berlin, 14195 Berlin</wicri:regionArea><placeName><region type="land" nuts="3">Berlin</region><settlement type="city">Berlin</settlement></placeName></affiliation></author><author><name sortKey="Fiehler, Jens" sort="Fiehler, Jens" uniqKey="Fiehler J" first="Jens" last="Fiehler">Jens Fiehler</name><affiliation wicri:level="1"><nlm:affiliation>Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg Eppendorf, 20251 Hamburg, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg Eppendorf, 20251 Hamburg</wicri:regionArea><wicri:noRegion>20251 Hamburg</wicri:noRegion><placeName><settlement type="city">Hambourg</settlement><region type="land" nuts="2">Hambourg</region></placeName></affiliation></author><author><name sortKey="Hanning, Uta" sort="Hanning, Uta" uniqKey="Hanning U" first="Uta" last="Hanning">Uta Hanning</name><affiliation wicri:level="1"><nlm:affiliation>Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg Eppendorf, 20251 Hamburg, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg Eppendorf, 20251 Hamburg</wicri:regionArea><wicri:noRegion>20251 Hamburg</wicri:noRegion><placeName><settlement type="city">Hambourg</settlement><region type="land" nuts="2">Hambourg</region></placeName></affiliation></author><author><name sortKey="Sporns, Peter" sort="Sporns, Peter" uniqKey="Sporns P" first="Peter" last="Sporns">Peter Sporns</name><affiliation wicri:level="1"><nlm:affiliation>Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg Eppendorf, 20251 Hamburg, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg Eppendorf, 20251 Hamburg</wicri:regionArea><wicri:noRegion>20251 Hamburg</wicri:noRegion><placeName><settlement type="city">Hambourg</settlement><region type="land" nuts="2">Hambourg</region></placeName></affiliation><affiliation wicri:level="1"><nlm:affiliation>Department of Neuroradiology, Clinic for Radiology and Nuclear Medicine, University Hospital Basel, 4031 Basel, Switzerland.</nlm:affiliation><country xml:lang="fr">Suisse</country><wicri:regionArea>Department of Neuroradiology, Clinic for Radiology and Nuclear Medicine, University Hospital Basel, 4031 Basel</wicri:regionArea><wicri:noRegion>4031 Basel</wicri:noRegion></affiliation></author></analytic><series><title level="j">Journal of clinical medicine</title><idno type="ISSN">2077-0383</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND AND PURPOSE</b></p><p>Intracranial hemorrhage has been observed in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (COVID-19), but the clinical, imaging, and pathophysiological features of intracranial bleeding during COVID-19 infection remain poorly characterized. This study describes clinical and imaging characteristics of patients with COVID-19 infection who presented with intracranial bleeding in a European multicenter cohort.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>This is a multicenter retrospective, observational case series including 18 consecutive patients with COVID-19 infection and intracranial hemorrhage. Data were collected from February to May 2020 at five designated European special care centers for COVID-19. The diagnosis of COVID-19 was based on laboratory-confirmed diagnosis of SARS-CoV-2. Intracranial bleeding was diagnosed on computed tomography (CT) of the brain within one month of the date of COVID-19 diagnosis. The clinical, laboratory, radiologic, and pathologic findings, therapy and outcomes in COVID-19 patients presenting with intracranial bleeding were analyzed.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>Eighteen patients had evidence of acute intracranial bleeding within 11 days (IQR 9-29) of admission. Six patients had parenchymal hemorrhage (33.3%), 11 had subarachnoid hemorrhage (SAH) (61.1%), and one patient had subdural hemorrhage (5.6%). Three patients presented with intraventricular hemorrhage (IVH) (16.7%).</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSION</b></p><p>This study represents the largest case series of patients with intracranial hemorrhage diagnosed with COVID-19 based on key European countries with geospatial hotspots of SARS-CoV-2. Isolated SAH along the convexity may be a predominant bleeding manifestation and may occur in a late temporal course of severe COVID-19.</p></div></front></TEI><pubmed><MedlineCitation Status="PubMed-not-MEDLINE" Owner="NLM"><PMID Version="1">32781623</PMID><DateRevised><Year>2020</Year><Month>09</Month><Day>05</Day></DateRevised><Article PubModel="Electronic"><Journal><ISSN IssnType="Print">2077-0383</ISSN><JournalIssue CitedMedium="Print"><Volume>9</Volume><Issue>8</Issue><PubDate><Year>2020</Year><Month>Aug</Month><Day>06</Day></PubDate></JournalIssue><Title>Journal of clinical medicine</Title><ISOAbbreviation>J Clin Med</ISOAbbreviation></Journal><ArticleTitle>Clinical and Imaging Characteristics in Patients with SARS-CoV-2 Infection and Acute Intracranial Hemorrhage.</ArticleTitle><ELocationID EIdType="pii" ValidYN="Y">E2543</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.3390/jcm9082543</ELocationID><Abstract><AbstractText Label="BACKGROUND AND PURPOSE" NlmCategory="OBJECTIVE">Intracranial hemorrhage has been observed in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (COVID-19), but the clinical, imaging, and pathophysiological features of intracranial bleeding during COVID-19 infection remain poorly characterized. This study describes clinical and imaging characteristics of patients with COVID-19 infection who presented with intracranial bleeding in a European multicenter cohort.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">This is a multicenter retrospective, observational case series including 18 consecutive patients with COVID-19 infection and intracranial hemorrhage. Data were collected from February to May 2020 at five designated European special care centers for COVID-19. The diagnosis of COVID-19 was based on laboratory-confirmed diagnosis of SARS-CoV-2. Intracranial bleeding was diagnosed on computed tomography (CT) of the brain within one month of the date of COVID-19 diagnosis. The clinical, laboratory, radiologic, and pathologic findings, therapy and outcomes in COVID-19 patients presenting with intracranial bleeding were analyzed.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">Eighteen patients had evidence of acute intracranial bleeding within 11 days (IQR 9-29) of admission. Six patients had parenchymal hemorrhage (33.3%), 11 had subarachnoid hemorrhage (SAH) (61.1%), and one patient had subdural hemorrhage (5.6%). Three patients presented with intraventricular hemorrhage (IVH) (16.7%).</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">This study represents the largest case series of patients with intracranial hemorrhage diagnosed with COVID-19 based on key European countries with geospatial hotspots of SARS-CoV-2. Isolated SAH along the convexity may be a predominant bleeding manifestation and may occur in a late temporal course of severe COVID-19.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Nawabi</LastName><ForeName>Jawed</ForeName><Initials>J</Initials><Identifier Source="ORCID">0000-0002-1137-0643</Identifier><AffiliationInfo><Affiliation>Department of Radiology (CCM), Charité-Universitätsmedizin Berlin, Campus Mitte, Humboldt-Universität zu Berlin, Freie Universität Berlin, 14195 Berlin, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Morotti</LastName><ForeName>Andrea</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Neurology Unit, ASST Valcamonica, Esine, 25040 Brescia, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wildgruber</LastName><ForeName>Moritz</ForeName><Initials>M</Initials><Identifier Source="ORCID">0000-0002-7228-6963</Identifier><AffiliationInfo><Affiliation>Klinik und Poliklinik für Radiologie, Klinikum der Universität (LMU), 81377 Munich, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Boulouis</LastName><ForeName>Gregoire</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Pediatric Radiology Department, Necker Enfants Malades & GHU Paris, Sainte-Anne Hospital, Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR S1266, INSERM, Université de Paris, 75015 Paris, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kraehling</LastName><ForeName>Hermann</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Department of Radiology, University Hospital Muenster, 48149 Muenster, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Schlunk</LastName><ForeName>Frieder</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Department of Neuroradiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 14195 Berlin, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Can</LastName><ForeName>Elif</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Department of Radiology (CCM), Charité-Universitätsmedizin Berlin, Campus Mitte, Humboldt-Universität zu Berlin, Freie Universität Berlin, 14195 Berlin, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kniep</LastName><ForeName>Helge</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg Eppendorf, 20251 Hamburg, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Thomalla</LastName><ForeName>Götz</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Department of Neurology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Psychogios</LastName><ForeName>Marios</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Neuroradiology, Clinic for Radiology and Nuclear Medicine, University Hospital Basel, 4031 Basel, Switzerland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hamm</LastName><ForeName>Bernd</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Department of Radiology (CCM), Charité-Universitätsmedizin Berlin, Campus Mitte, Humboldt-Universität zu Berlin, Freie Universität Berlin, 14195 Berlin, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Fiehler</LastName><ForeName>Jens</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg Eppendorf, 20251 Hamburg, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hanning</LastName><ForeName>Uta</ForeName><Initials>U</Initials><AffiliationInfo><Affiliation>Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg Eppendorf, 20251 Hamburg, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sporns</LastName><ForeName>Peter</ForeName><Initials>P</Initials><Identifier Source="ORCID">0000-0002-3028-0539</Identifier><AffiliationInfo><Affiliation>Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg Eppendorf, 20251 Hamburg, Germany.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Neuroradiology, Clinic for Radiology and Nuclear Medicine, University Hospital Basel, 4031 Basel, Switzerland.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>08</Month><Day>06</Day></ArticleDate></Article><MedlineJournalInfo><Country>Switzerland</Country><MedlineTA>J Clin Med</MedlineTA><NlmUniqueID>101606588</NlmUniqueID><ISSNLinking>2077-0383</ISSNLinking></MedlineJournalInfo><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">COVID-19</Keyword><Keyword MajorTopicYN="N">SARS-CoV-2</Keyword><Keyword MajorTopicYN="N">imaging characteristics</Keyword><Keyword MajorTopicYN="N">intracranial hemorrhage</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>06</Month><Day>11</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2020</Year><Month>07</Month><Day>29</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>08</Month><Day>05</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>8</Month><Day>13</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate 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