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{| class="wikitable" | |||
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! style="background: #4479BA; color: #FFFFFF; text-align: center;" rowspan="2" |<small>Patient</small> | |||
! style="background: #4479BA; color: #FFFFFF; text-align: center;" rowspan="2" |<small>Past Medical History</small> | |||
! style="background: #4479BA; color: #FFFFFF; text-align: center;" rowspan="2" |<small>Later presentation</small> | |||
! style="background: #4479BA; color: #FFFFFF; text-align: center;" rowspan="2" |<small>GCS</small> | |||
! style="background: #4479BA; color: #FFFFFF; text-align: center;" colspan="2" |<small>Lab. Findings</small> | |||
! style="background: #4479BA; color: #FFFFFF; text-align: center;" rowspan="2" |<small>Specific Tests</small> | |||
! style="background: #4479BA; color: #FFFFFF; text-align: center;" colspan="2" |<small>Imaging studies</small> | |||
|- | |||
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |<small>CBC</small> | |||
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |<small>CSF</small> | |||
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |<small>MRI/CT scan</small> | |||
|- | |||
|1. 84 year old man from France presented with dyspnea and cough'''<ref name="ZayetKlopfenstein2020">{{cite journal|last1=Zayet|first1=Souheil|last2=Klopfenstein|first2=Timothée|last3=Kovẚcs|first3=Róbert|last4=Stancescu|first4=Silviu|last5=Hagenkötter|first5=Beate|title=Acute Cerebral Stroke with Multiple Infarctions and COVID-19, France, 2020|journal=Emerging Infectious Diseases|volume=26|issue=9|year=2020|issn=1080-6040|doi=10.3201/eid2609.201791}}</ref>''' | |||
|[[Diabetes Mellitus]], | |||
[[Arterial Hypertension]], | |||
[[Atrial fibrillation]], | |||
[[Peripheral Arterial Disease]], | |||
[[Coronary Heart Disease]] | |||
|Worsening [[headache]], [[Sore throat|Sore throat.]] (Day 5) | |||
Impaired [[consciousness]] and transient [[generalized seizure]], (Day 9) | |||
|E4V1M1 | |||
|↑[[WBC|WBCs]] and [[neutrophils]]<br />↓[[lymphocytes]] | |||
↑ [[CRP]] | |||
|Clear and colorless fluid, | |||
[[Pressure]]=320 mmH<sub>2</sub>O, | |||
[[Cell]] count was 12/μL–10 | |||
[[Mononuclear cells|mononuclear]] and 2 [[polymorphonuclear cells]] | |||
|[[RT-PCR]] of [[SARS-CoV-2]] [[RNA]] was positive in [[CSF]] | |||
|Brain [[MRI]]: | |||
Hyperintensity in the right lateral [[Ventricle|ventricle's]] inferior horn along the wall, | |||
pan-[[Paranasal sinus|paranasal]] [[sinusitis]]. | |||
|- | |||
|2. 35-year-old woman from Turkey<ref name="pmid32479911" /> | |||
|[[Flu]] like [[Symptom|symptoms]] | |||
|[[Headache]], [[nausea]], [[dizziness]], and | |||
drug-[[refractory]] [[seizure]]<nowiki/>s. | |||
|E4V5M6 | |||
|NA | |||
|NA | |||
|[[RT-PCR]] and [[antibody tests]] positive | |||
|Brain [[MRI]]: Hyperintensity in the left [[temporal lobe]]. | |||
MR [[Spectroscopy]]: Decrease [[N-acetyl aspartate]] peak along with a marked elevated [[choline]] peak. | |||
|- | |||
|3. 31-year-old African American woman<ref name="pmid32487282">{{cite journal| author=Benameur K, Agarwal A, Auld SC, Butters MP, Webster AS, Ozturk T | display-authors=etal| title=Encephalopathy and Encephalitis Associated with Cerebrospinal Fluid Cytokine Alterations and Coronavirus Disease, Atlanta, Georgia, USA, 2020. | journal=Emerg Infect Dis | year= 2020 | volume= 26 | issue= 9 | pages= | pmid=32487282 | doi=10.3201/eid2609.202122 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32487282 }}</ref> | |||
|[[SCD]] patient with [[dyspnea]] | |||
|[[Paralysis]] and [[sedation]] (Day 13) | |||
[[Comatose]] (Day 15) and death (Day 16) | |||
|E0V0M0 | |||
|NA | |||
|[[Pressure]]=30cmH<sub>2</sub>O | |||
115 nucleated cell /ml | |||
7374 [[erythrocytes]] | |||
/ml | |||
[[Protein]]> 200mg/dl | |||
<br /> | |||
|[[Reverse transcriptase PCR|RT=PCR]] for [[SARS-CoV-2]] was positive in [[Nasopharyngeal|nasopharyngea]]<nowiki/>l [[Swabbing|swab]] | |||
|Brain [[MRI]]: Nonenhancing [[cerebral edema]] and restricted [[diffusion]] in the right [[cerebral hemisphere]] with [[brain herniation]]. | |||
|} | |||
Revision as of 05:26, 12 July 2020
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Syncope is classified yo three categories:
- Vasovagal
- Neurogenic
- Cardiovascular.
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| DDx of syncope | ||||
|---|---|---|---|---|
| Patient | Past Medical History | Later presentation | GCS | Lab. Findings | Specific Tests | Imaging studies | ||
|---|---|---|---|---|---|---|---|---|
| CBC | CSF | MRI/CT scan | ||||||
| 1. 84 year old man from France presented with dyspnea and cough[1] | Diabetes Mellitus,
Arterial Hypertension, Atrial fibrillation, Peripheral Arterial Disease, |
Worsening headache, Sore throat. (Day 5)
Impaired consciousness and transient generalized seizure, (Day 9) |
E4V1M1 | ↑WBCs and neutrophils ↓lymphocytes ↑ CRP |
Clear and colorless fluid,
Pressure=320 mmH2O, Cell count was 12/μL–10 |
RT-PCR of SARS-CoV-2 RNA was positive in CSF | Brain MRI:
Hyperintensity in the right lateral ventricle's inferior horn along the wall, | |
| 2. 35-year-old woman from Turkey[2] | Flu like symptoms | Headache, nausea, dizziness, and
drug-refractory seizures. |
E4V5M6 | NA | NA | RT-PCR and antibody tests positive | Brain MRI: Hyperintensity in the left temporal lobe.
MR Spectroscopy: Decrease N-acetyl aspartate peak along with a marked elevated choline peak. | |
| 3. 31-year-old African American woman[3] | SCD patient with dyspnea | Paralysis and sedation (Day 13)
Comatose (Day 15) and death (Day 16) |
E0V0M0 | NA | Pressure=30cmH2O
115 nucleated cell /ml 7374 erythrocytes /ml Protein> 200mg/dl
|
RT=PCR for SARS-CoV-2 was positive in nasopharyngeal swab | Brain MRI: Nonenhancing cerebral edema and restricted diffusion in the right cerebral hemisphere with brain herniation. | |
- ↑ Zayet, Souheil; Klopfenstein, Timothée; Kovẚcs, Róbert; Stancescu, Silviu; Hagenkötter, Beate (2020). "Acute Cerebral Stroke with Multiple Infarctions and COVID-19, France, 2020". Emerging Infectious Diseases. 26 (9). doi:10.3201/eid2609.201791. ISSN 1080-6040.
- ↑
- ↑ Benameur K, Agarwal A, Auld SC, Butters MP, Webster AS, Ozturk T; et al. (2020). "Encephalopathy and Encephalitis Associated with Cerebrospinal Fluid Cytokine Alterations and Coronavirus Disease, Atlanta, Georgia, USA, 2020". Emerg Infect Dis. 26 (9). doi:10.3201/eid2609.202122. PMID 32487282 Check
|pmid=value (help).