Covid-19 is a unique disease affecting almost all organs of body. During current wave of this pandemic our nervous system, especially brain has been affected in various forms leading to serious complications”, said, Dr Anurag Saxena, HOD- Consultant, Neuro Surgeon, HCMCT Manipal Hospitals, Dwarka, New Delhi.
He further added, “Commonly observed condition involving brain includes: Encephalopathy, which encompasses alterations in mental state such as confusion, disorientation and agitation, is a rare neurological manifestation of Covid-19 as a whole."
However, it is seen very commonly among severely infected patients who have developed ARDS. Delirium or coma are the typical presentations in these patients. Infectious Encephalitis-like pictures have also been reported. Usually, the symptoms include fever and seizures. These patients can later develop ischemic stroke, and some cases go on to develop massive cerebral edema which necessitate emergency decompressive craniectomies. The virus itself has rarely been isolated from CSF or brain tissue, though, and on the few instances that it has, the viral RNA loads have been modest at best, he added.
Ischemic Stroke- several studies have shown that SARS-CoV-2 infection can cause a highly prothrombic state in the human body, which predisposes the development of thromboembolic stroke. Widespread microthrombi and patches of infarcts in the brain have been reported in autopsies of several Covid patients who were critically ill. As mentioned previously, patients who develop encephalitis are also likely to develop ischemic stroke. Cardiac arrythmias have also been reported as a complication of Covid infection, and this is another potential source of embolism. Intracranial Haemorrhage has been seen in patients during infection or soon after recovery.