<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2631-2581</journal-id>
<journal-title><![CDATA[Revista Ecuatoriana de Neurología]]></journal-title>
<abbrev-journal-title><![CDATA[Rev Ecuat Neurol]]></abbrev-journal-title>
<issn>2631-2581</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Médica Ecuatoriana de Neurología]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2631-25812022000100108</article-id>
<article-id pub-id-type="doi">10.46997/revecuatneurol31100108</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Hemorragia Intracerebral Espontánea En Pacientes Con Covid-19 Severa: Reporte De Dos Casos]]></article-title>
<article-title xml:lang="en"><![CDATA[Spontaneous Intracerebral Hemorrhage In Severe Covid-19 Patients: Report Of Two Cases]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[González-Arteaga]]></surname>
<given-names><![CDATA[Alex]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pérez-Ortiz]]></surname>
<given-names><![CDATA[Jenniffer]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Molina-Varas]]></surname>
<given-names><![CDATA[Eduardo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cedeño-Torres]]></surname>
<given-names><![CDATA[Francisco]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Galarza-Bernita]]></surname>
<given-names><![CDATA[David]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad Católica de Santiago de Guayaquil Facultad de Ciencias Médicas ]]></institution>
<addr-line><![CDATA[Guayaquil ]]></addr-line>
<country>Ecuador</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital Naval de Guayaquil Servicio de Medicina Interna Departamento de Clínica]]></institution>
<addr-line><![CDATA[Guayaquil ]]></addr-line>
<country>Ecuador</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>07</month>
<year>2022</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>07</month>
<year>2022</year>
</pub-date>
<volume>31</volume>
<numero>1</numero>
<fpage>108</fpage>
<lpage>112</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.senescyt.gob.ec/scielo.php?script=sci_arttext&amp;pid=S2631-25812022000100108&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.senescyt.gob.ec/scielo.php?script=sci_abstract&amp;pid=S2631-25812022000100108&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.senescyt.gob.ec/scielo.php?script=sci_pdf&amp;pid=S2631-25812022000100108&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen El sistema respiratorio es el principalmente afecto en la infección por SARS-CoV-2, produciendo el síndrome respiratorio agudo severo como principal complicación en COVID-19, además los pacientes con enfermedad severa desarrollan insuficiencia multiorgánica; entre estos destacamos el sistema nervioso, por su potencial neurotropismo. Los datos clínicos recientes revelan que los pacientes pueden manifestar síntomas como anosmia, disgeusia, deterioro de conciencia, cefalea, convulsiones y enfermedad cerebrovascular (ECV), incluida la hemorragia cerebral y el accidente cerebrovascular isquémico. Se describen dos pacientes varones físicamente activos con infección complicada por SARS-CoV-2 sin comorbilidades significativas para el desarrollo de hemorragia intracraneal, ni antecedentes de traumatismo craneoencefálico o malformaciones anatómicas documentadas. Ambos ingresaron por el área de emergencia y en su estancia en UCI desarrollaron hemorragia intracraneal diagnosticada por tomografía computarizada. Los hallazgos paraclínicos en los dos casos fueron compatibles con un estado protrombótico, como posibles etiologías del sangrado en ambos pacientes.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract The respiratory system is mainly affected by the SARS-CoV-2 infection, producing a severe acute respiratory syndrome known as COVID-19 (Coronavirus disease 2019), patients with severe disease usually develop multiorgan failure; among these we can focus on the nervous system, due to its potential neurotropism. Recent clinical data reveal that patients may manifest symptoms such as anosmia, dysgeusia, impaired consciousness, headache, seizures, and cerebrovascular disease (CVD). We describe two physically active male patients with complicated SARS-CoV-2 infection without significant comorbidities related to the development of intracranial hemorrhage, nor a history of head trauma or documented anatomic malformations. Both were admitted by the emergency department and during their stay in the ICU they developed intracranial hemorrhage diagnosed by computed tomography. The paraclinical findings in the two cases were compatible with a prothrombotic state as possible etiologies of bleeding in both.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[SARS-CoV-2]]></kwd>
<kwd lng="es"><![CDATA[hemorragia intracraneal]]></kwd>
<kwd lng="es"><![CDATA[estado protrombótico.]]></kwd>
<kwd lng="en"><![CDATA[SARS-Cov2]]></kwd>
<kwd lng="en"><![CDATA[intracranial hemorrhage]]></kwd>
<kwd lng="en"><![CDATA[prothrombotic state.]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Neurological manifestations of COVID-19 and other coronavirus infections: A systematic review.]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Montalvan]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Lee]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Bueso]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[De Toledo]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Rivas]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
</person-group>
<source><![CDATA[Clin Neurol Neurosurg]]></source>
<year>2020</year>
<volume>194</volume>
<page-range>105921</page-range></nlm-citation>
</ref>
<ref id="B2">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Neurological Manifestations of COVID-19: A systematic review and current update.]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Whittaker]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Anson]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Harky]]></surname>
<given-names><![CDATA[A.]]></given-names>
</name>
</person-group>
<source><![CDATA[Acta Neurol Scand]]></source>
<year>2020</year>
<volume>142</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>14-22</page-range></nlm-citation>
</ref>
<ref id="B3">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Neurologic Manifestations of Hospitalized Patients With Coronavirus Disease 2019 in Wuhan, China]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mao]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Jin]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Wang]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Hu]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Chen]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[He]]></surname>
<given-names><![CDATA[Q]]></given-names>
</name>
</person-group>
<source><![CDATA[JAMA Neurol]]></source>
<year>2020</year>
</nlm-citation>
</ref>
<ref id="B4">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Neuropathogenesis and Neurologic Manifestations of the Coronaviruses in the Age of Coronavirus Disease 2019: A Review.]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Zubair]]></surname>
<given-names><![CDATA[AS]]></given-names>
</name>
<name>
<surname><![CDATA[McAlpine]]></surname>
<given-names><![CDATA[LS]]></given-names>
</name>
<name>
<surname><![CDATA[Gardin]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Farhadian]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Kuruvilla]]></surname>
<given-names><![CDATA[DE]]></given-names>
</name>
<name>
<surname><![CDATA[Spudich]]></surname>
<given-names><![CDATA[S.]]></given-names>
</name>
</person-group>
<source><![CDATA[JAMA Neurol]]></source>
<year>2020</year>
</nlm-citation>
</ref>
<ref id="B5">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Neurological manifestations and complications of COVID-19: A literature review.]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ahmad]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Rathore]]></surname>
<given-names><![CDATA[FA]]></given-names>
</name>
</person-group>
<source><![CDATA[J Clin Neurosci Off J Neurosurg Soc Australas]]></source>
<year>2020</year>
<month>.</month>
</nlm-citation>
</ref>
<ref id="B6">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Hemorrhagic stroke in hispanics with severe SARS-CoV2 infection.]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Castillo]]></surname>
<given-names><![CDATA[PR]]></given-names>
</name>
<name>
<surname><![CDATA[Del Brutto]]></surname>
<given-names><![CDATA[OH]]></given-names>
</name>
<name>
<surname><![CDATA[Mautong]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[García]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Tovar]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Middlebrooks]]></surname>
<given-names><![CDATA[EH]]></given-names>
</name>
</person-group>
<source><![CDATA[J Neurol Sci.]]></source>
<year>2020</year>
<volume>416</volume>
<page-range>117046</page-range></nlm-citation>
</ref>
<ref id="B7">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Neurological complications of COVID-19]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Newcombe]]></surname>
<given-names><![CDATA[VFJ]]></given-names>
</name>
<name>
<surname><![CDATA[Dangayach]]></surname>
<given-names><![CDATA[NS]]></given-names>
</name>
<name>
<surname><![CDATA[Sonneville]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<source><![CDATA[Intensive Care Med.]]></source>
<year>2021</year>
<month>.</month>
</nlm-citation>
</ref>
<ref id="B8">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Neurological and neuropsychiatric complications of COVID-19 in 153 patients: a UK-wide surveillance study]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Varatharaj]]></surname>
<given-names><![CDATA[Aravinthan]]></given-names>
</name>
</person-group>
<source><![CDATA[The Lancet.]]></source>
<year>2020</year>
<volume>7</volume>
</nlm-citation>
</ref>
<ref id="B9">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Neurological manifestations associated with COVID-19: a multicentric registry.]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Meppiel]]></surname>
<given-names><![CDATA[E.]]></given-names>
</name>
</person-group>
<source><![CDATA[Clin Microbiol Infect]]></source>
<year>2020</year>
</nlm-citation>
</ref>
<ref id="B10">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Stroke in COVID-19: a systematic review and meta-analysis.]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Nannoni]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[de Groot]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Bell]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Markus]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
</person-group>
<source><![CDATA[Int. J Stroke]]></source>
<year>2021</year>
<volume>16</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>137-49</page-range></nlm-citation>
</ref>
<ref id="B11">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Neurological complications in patients with SARS-CoV-2 infection: a systematic review.]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Munhoz]]></surname>
<given-names><![CDATA[RP]]></given-names>
</name>
<name>
<surname><![CDATA[Pedroso]]></surname>
<given-names><![CDATA[JL]]></given-names>
</name>
<name>
<surname><![CDATA[Nascimento]]></surname>
<given-names><![CDATA[FA]]></given-names>
</name>
<name>
<surname><![CDATA[Almeida]]></surname>
<given-names><![CDATA[SM de]]></given-names>
</name>
<name>
<surname><![CDATA[Barsottini]]></surname>
<given-names><![CDATA[OGP]]></given-names>
</name>
<name>
<surname><![CDATA[Cardoso]]></surname>
<given-names><![CDATA[FEC]]></given-names>
</name>
</person-group>
<source><![CDATA[Arq Neuropsiquiatr]]></source>
<year>2020</year>
<volume>78</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>290-300.</page-range></nlm-citation>
</ref>
<ref id="B12">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Nervous system involvement after infection with COVID-19 and other coronaviruses.]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Wu]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Xu]]></surname>
<given-names><![CDATA[X]]></given-names>
</name>
<name>
<surname><![CDATA[Chen]]></surname>
<given-names><![CDATA[Z]]></given-names>
</name>
<name>
<surname><![CDATA[Duan]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Hashimoto]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Yang]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<source><![CDATA[Brain Behav Immun]]></source>
<year>2020</year>
</nlm-citation>
</ref>
<ref id="B13">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Hyperinflammation and derangement of renin-angiotensin-aldosterone system in COVID-19: A novel hypothesis for clinically suspected hypercoagulopathy and microvascular immunothrombosis]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Henry]]></surname>
<given-names><![CDATA[BM]]></given-names>
</name>
<name>
<surname><![CDATA[Vikse]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Benoit]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Favaloro]]></surname>
<given-names><![CDATA[EJ]]></given-names>
</name>
<name>
<surname><![CDATA[Lippi]]></surname>
<given-names><![CDATA[G.]]></given-names>
</name>
</person-group>
<source><![CDATA[Clin Chim Acta]]></source>
<year>2020</year>
<volume>507</volume>
<page-range>167-73</page-range></nlm-citation>
</ref>
<ref id="B14">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[COVID-19-Related Stroke]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hess]]></surname>
<given-names><![CDATA[DC]]></given-names>
</name>
<name>
<surname><![CDATA[Eldahshan]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
<name>
<surname><![CDATA[Rutkowski]]></surname>
<given-names><![CDATA[E.]]></given-names>
</name>
</person-group>
<source><![CDATA[Transl Stroke Res]]></source>
<year>2020</year>
<volume>11</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>322-5</page-range></nlm-citation>
</ref>
<ref id="B15">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[COVID-19-associated meningoencephalitis complicated with intracranial hemorrhage: a case report]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Al-olama]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<source><![CDATA[Acta Neurochir.]]></source>
<year>2020</year>
<volume>162</volume>
<page-range>1495-1499.</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
