Coronavirus Disease 2019 Complicated by Multiple Simultaneous Intracerebral Hemorrhages

Intern Med. 2020 Oct 15;59(20):2597-2600. doi: 10.2169/internalmedicine.5697-20. Epub 2020 Sep 5.


The relationship between coronavirus disease 2019 (COVID-19) and intracerebral hemorrhage remains unclear. We herein report a case of severe COVID-19 pneumonia complicated by multiple simultaneous intracerebral hemorrhages (MSICH). The patient died eight days after the episode of MSICH. No apparent coagulopathy was observed; however, extracorporeal membrane oxygenation and anticoagulation might have caused the occurrence of MSICH. Laboratory findings showed hypercoagulability, suggesting that thrombotic etiologies, such as sinus thrombosis or cerebral infarction, might also have caused MSICH. MSICH can occur as a fatal complication of COVID-19, and this should be considered when providing treatment.

Keywords: COVID-19; ECMO; SARS-CoV-2; anticoagulant; hypercoagulability; intracerebral hemorrhage.

Publication types

  • Case Reports

MeSH terms

  • Betacoronavirus* / isolation & purification
  • Cerebral Hemorrhage / diagnosis
  • Cerebral Hemorrhage / virology*
  • Clinical Laboratory Techniques
  • Coronavirus Infections / complications
  • Coronavirus Infections / diagnosis*
  • Fatal Outcome
  • Humans
  • Male
  • Middle Aged
  • Pandemics
  • Pneumonia, Viral / complications
  • Pneumonia, Viral / diagnosis*

Supplementary concepts

  • COVID-19
  • COVID-19 diagnostic testing
  • severe acute respiratory syndrome coronavirus 2