{"doi":"10.7759/cureus.10159","title":"Intracranial Hemorrhage in a Patient With COVID-19: Possible Explanations and Considerations","abstract":null,"journal":"Cureus","year":2020,"id":623573,"datarank":1.3125445531766107,"base_score":3.2188758248682006,"endowment":3.2188758248682006,"self_citation_contribution":0.48283137373023016,"citation_network_contribution":0.8297131794463805,"self_endowment_contribution":0.48283137373023016,"citer_contribution":0.8297131794463805,"corpus_percentile":null,"corpus_rank":null,"citation_count":24,"citer_count":23,"citers_with_citation_signal":14,"citers_with_endowment":14,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":823625,"name":"Xiang Fang","orcid":"0000-0002-3782-0366","position":1,"is_corresponding":false},{"id":631099,"name":"Prashant Rai","orcid":"0000-0003-0258-4567","position":2,"is_corresponding":false},{"id":1611598,"name":"Bhanu Gogia","orcid":null,"position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Intracranial Hemorrhage in a Patient With COVID-19: Possible Explanations and Considerations","abstract":"Some of the reported neurological manifestations of COVID-19 are encephalopathy, headache, ischemic, hemorrhagic stroke, Miller Fisher syndrome, cranial neuropathies, and Guillain-Barre syndrome. We report a case of a 75-year-old COVID-19 patient with life-threatening intracranial hemorrhage. The initial labs on admission showed D-dimer of 1.04 µg/mL, which increased to 3.74 µg/mL the next day, PT/INR of 13.7 seconds/1.2, aPTT of 22 seconds, fibrinogen of 386 mg/dL, WBC of 9.71 K/µL, Hgb of 14.1 g/dL, platelet of 315 x 103/µL, LDH of 965 U/L, and CRP of 35.2 mg/dL. In addition to aspirin and Plavix (clopidogrel), the patient was started on a therapeutic dose of enoxaparin due to elevated D-dimer. A few days later, the patient had a change in the neurological examination. The CT of the head without contrast revealed a left-sided acute subdural hematoma, causing left to right midline shift, a large left temporal intraparenchymal, and subarachnoid hemorrhage with transtentorial herniation, leading to death. This case illustrates a combination of factors including hypertension, triple therapy (aspirin, clopidogrel, and enoxaparin), and underlying coagulopathy due to COVID-19, which contributed to the life-threatening intracranial hemorrhage in this patient. Therefore, this raises a concern about the safety of starting these patients preemptively on a therapeutic dose of anticoagulation.","is_dataset_classified":null,"base_score":3.2188758248682006,"endowment":3.2188758248682006,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"32884879","pmcid":"PMC7462644","openalex_id":"https://openalex.org/W3081781587","authors":[],"funders":[],"total_grants":0,"fwci":1.6472,"citation_percentile":0.87704612,"influential_citations":0,"citation_trend":[{"year":2018,"count":1},{"year":2020,"count":2},{"year":2021,"count":10},{"year":2022,"count":5},{"year":2023,"count":2},{"year":2024,"count":1},{"year":2025,"count":1},{"year":2026,"count":1}],"oa_status":"gold","license":"cc-by","oa_locations":[{"url":"https://assets.cureus.com/uploads/case_report/pdf/40236/1612431176-1612431167-20210204-18268-5ntbg.pdf","host_type":"journal"},{"url":"https://assets.cureus.com/uploads/case_report/pdf/40236/1612431176-1612431167-20210204-18268-5ntbg.pdf","host_type":"publisher"},{"url":"https://www.cureus.com/articles/40236-intracranial-hemorrhage-in-a-patient-with-covid-19-possible-explanations-and-considerations","host_type":"publisher"},{"url":"https://doi.org/10.7759/cureus.10159","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/32884879","host_type":"repository"},{"url":"https://www.ncbi.nlm.nih.gov/pmc/articles/7462644","host_type":"repository"},{"url":"https://europepmc.org/articles/PMC7462644","host_type":"Europe_PMC"},{"url":"https://europepmc.org/articles/PMC7462644?pdf=render","host_type":"Europe_PMC"}],"fields_of_study":["Long-Term Effects of COVID-19","Traumatic Brain Injury and Neurovascular Disturbances","Cerebrospinal fluid and hydrocephalus"],"mesh_terms":[],"keywords":["Medicine","Aspirin","Anesthesia","Subarachnoid hemorrhage","Intraparenchymal hemorrhage","Clopidogrel","Midline shift","Coagulopathy","Hematoma","Stroke (engine)","Surgery","Internal medicine","Covid-19 And Ich","Covid-19 Neurological Outcomes","Fatal Outcomes Covid-19","Intracranial Hemorrhage And Sars-Cov-2","Stroke And Covid-19"],"sdg_mappings":[{"sdg_number":0,"sdg_label":"Good health and well-being"}],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[{"name":"doi"}],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-04T00:24:04.509261Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}