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Papers of the Week

2022 May 23

Int J Neurosci

De novo intracranial aneurysm formation in SARS-CoV-2 infection: first report of a yet unknown complication.


Marco C, Alberto B, Marcella C, Irene F, Gianluigi Z, Pietro F
Int J Neurosci. 2022 May 23:1-6.
PMID: 35603452.


Background and ImportanceCOVID-19 is a viral infection that mainly affects the respiratory tract, but can also cause multiple inflammatory reactions, including neurological and cerebrovascular manifestations. We report the case of a COVID-19 patient who developed 'de novo' multiple cerebral aneurysms with no risk factors for aneurysm formation.Clinical PresentationA 55-year-old man with SARS-CoV-2 infection came to our attention for left eye blindness accompanied by ptosis, palpebral chemosis and retro-orbital pain. Brain CT and CT-angiography were negative for hemorrhages and for vascular malformations. Repeated intracerebral hemorrhages and neurological deterioration then occurred, and a new CT-angiography showed multiple intracranial aneurysms that were not present before.ConclusionIntracranial aneurysm formation as a complication of COVID-19 has not been previously reported. As other viral infections do, COVID-19 may be able to determine a vascular damage that can ultimately lead to development of an aneurysm. It is reasonable to hypothesize an involvement of the renin-angiotensin system as a pathogenic mechanism.A conservative therapy aiming at inflammatory modulation and vascular damage prevention may be warranted in these patients.