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PubMed: 32526365 DOI: 10.1016/j.wneu.2020.06.016

Acute Hemorrhage After Intracerebral Biopsy in COVID-19 Patients: Report of 3 Cases.

World Neurosurg 141:157-161

Authors: Aurélie Degeneffe, Michaël Bruneau, Julien Spitaels, Nathalie Gilis, Olivier De Witte, Alphonse Lubansu

Affiliations

  • Department of Neurosurgery, Erasmus Hospital, Brussels, Belgium.
  • Department of Neurosurgery, Erasmus Hospital, Brussels, Belgium.

Abstract

BACKGROUND

When Belgium's coronavirus disease 2019 (COVID-19) outbreak began in March 2020, our neurosurgical department followed the protocol of most surgical departments in the world and postponed elective surgery. However, patients with tumor-like brain lesions requiring urgent surgery still received treatment as usual, in order to ensure ongoing neurooncologic care. From a series of 31 patients admitted for brain surgery, 3 were confirmed as infected by the novel severe acute respiratory syndrome coronavirus 2.

CASE DESCRIPTION

We present the clinical outcomes of these 3 COVID-19 patients, who underwent an intracerebral biopsy in our department during April 2020. All suffered from a diffuse intraparenchymal hemorrhage postoperatively. Unfortunately, we were not able to identify a clear etiology of these postoperative complications. It could be hypothesized that an active COVID-19 infection status may be related to a higher bleeding risk. The remaining 28 neurooncologic non-COVID-19 patients underwent uneventful surgery during the same period.

CONCLUSIONS

This case series reports the previously unreported and unexpected outcomes of COVID-19 patients suffering from acute hemorrhage after intracerebral biopsy procedures. Although no direct relation can yet be established, we recommend the neurosurgical community be cautious in such cases.

MeSH

Coronavirus, Hemorrhage, Brain, Biopsy, Covid-19, Neurosurgical Procedures

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