Potential Mechanisms of COVID-19-related Intracranial Hemorrhage Due to Temporary Depletion of Vitamin K-dependent Coagulation Factors: An Illustrative Case

Narihide Shinoda; Shogo Tamura; Masafumi Mori; Mitsugu Nakamura; Kazuyoshi Korosue; Shigeru Kose

doi:10.2176/jns-nmc.2021-0295

Potential Mechanisms of COVID-19-related Intracranial Hemorrhage Due to Temporary Depletion of Vitamin K-dependent Coagulation Factors: An Illustrative Case

NMC Case Rep J. 2022 Apr 1:9:63-67. doi: 10.2176/jns-nmc.2021-0295. eCollection 2022.

Authors

Narihide Shinoda¹, Shogo Tamura¹, Masafumi Mori¹, Mitsugu Nakamura¹, Kazuyoshi Korosue², Shigeru Kose¹

Affiliations

¹ Department of Neurosurgery, Kosei Hospital, Kobe, Hyogo, Japan.
² Department of Neurosurgery, Kosei Kanoko Hospital, Kobe, Hyogo, Japan.

Abstract

Coronavirus disease 2019 (COVID-19)-related intracranial hemorrhage (ICH) is believed to be associated with at least one known risk factor for ICH, such as hypertension, hyperlipidemia, diabetes mellitus, severe pneumonia, or anticoagulation therapy. However, in this study, we report a case of ICH in a 14-year-old boy with mild COVID-19 infection without pneumonia who had no such risk factors. The only abnormal laboratory finding was temporary depletion of vitamin K-dependent coagulation factors. This case indicates that COVID-19 infection may cause simultaneous asymptomatic intracranial microhemorrhages and temporary depletion of vitamin K-dependent coagulation factors. This temporary depletion might transform the intracranial microhemorrhages into symptomatic ICH.

Keywords: COVID-19-related ICH; Coronavirus disease 2019 (COVID-19); angiotensin-converting enzyme 2 (ACE2); vitamin K-dependent coagulation factors.

Publication types

Case Reports