{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T00:06:09Z","timestamp":1764720369022,"version":"3.46.0"},"reference-count":17,"publisher":"Georg Thieme Verlag KG","issue":"04","license":[{"start":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T00:00:00Z","timestamp":1757289600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Asian J Neurosurg"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Coronavirus disease 2019 (COVID-19) can lead to systemic vascular complications, such as endothelial damage and hypercoagulability. Although COVID-19-associated nonaneurysmal subarachnoid hemorrhage (SAH) has been reported, cases involving anterior cerebral artery (ACA) dissection, particularly in the A1 segment, are extremely rare. A 57-year-old man with a recent COVID-19 infection was brought to the emergency department in an unconscious state. Imaging revealed diffuse SAH, and computed tomography angiography identified dissection of the right ACA A1 segment. Urgent surgical intervention with clipping of the dissected segment was performed. Although the patient initially stabilized postoperatively, he subsequently developed severe cerebral infarction, leading to progressive neurological decline. Despite intensive care, the patient succumbed to these complications 10 days after the initial presentation. Although the overall threat of COVID-19 has diminished, vigilance is still required because its vascular complications remain potentially fatal. COVID-19-associated SAH may have a higher mortality rate due to mechanisms distinct from saccular aneurysm rupture, such as arterial dissection and systemic effects. Dissecting an aneurysm of the A1 segment of the ACA is an extremely rare but serious complication, and its management remains challenging. Further studies are required to understand and mitigate COVID-19-related vascular pathologies.<\/jats:p>","DOI":"10.1055\/s-0045-1811244","type":"journal-article","created":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T23:02:49Z","timestamp":1757372569000},"page":"870-874","source":"Crossref","is-referenced-by-count":0,"title":["Anterior Cerebral Artery Dissection Leading to Severe Subarachnoid Hemorrhage in a Post-Pandemic COVID-19 Patient: A Case Report and a Call for Continued Vigilance"],"prefix":"10.1055","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5318-3715","authenticated-orcid":false,"given":"Sho","family":"Hanai","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Tsukuba Memorial Hospital, Tsukuba, Ibaraki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kiyoyuki","family":"Yanaka","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Tsukuba Memorial Hospital, Tsukuba, Ibaraki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Minami","family":"Saura","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Tsukuba Memorial Hospital, Tsukuba, Ibaraki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2144-663X","authenticated-orcid":false,"given":"Toshihide","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Tsukuba Memorial Hospital, Tsukuba, Ibaraki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hitoshi","family":"Aiyama","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Tsukuba Memorial Hospital, Tsukuba, Ibaraki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aiki","family":"Marushima","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eiichi","family":"Ishikawa","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,9,8]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"711616","DOI":"10.3389\/fpubh.2021.711616","article-title":"COVID-19: pulmonary and extra pulmonary manifestations","volume":"9","author":"I H Elrobaa","year":"2021","journal-title":"Front Public Health"},{"issue":"03","key":"ref2","doi-asserted-by":"crossref","first-page":"CASE21160","DOI":"10.3171\/CASE21160","article-title":"Cerebral vasculopathy and strokes in a child with COVID-19 antibodies: illustrative case","volume":"2","author":"C H Foster","year":"2021","journal-title":"J Neurosurg Case Lessons"},{"issue":"11","key":"ref3","doi-asserted-by":"crossref","first-page":"CASE20163","DOI":"10.3171\/CASE20163","article-title":"Spontaneous intracranial hemorrhage presenting in a patient with vitamin K deficiency and COVID-19: illustrative case","volume":"1","author":"N R Ellens","year":"2021","journal-title":"J Neurosurg Case Lessons"},{"issue":"04","key":"ref4","doi-asserted-by":"crossref","first-page":"e0248728","DOI":"10.1371\/journal.pone.0248728","article-title":"Impact of COVID-19 on the hospitalization, treatment, and outcomes of intracerebral and subarachnoid hemorrhage in the United States","volume":"16","author":"V M Ravindra","year":"2021","journal-title":"PLoS One"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"524","DOI":"10.25259\/SNI_974_2022","article-title":"Nonaneurysmal subarachnoid hemorrhage associated with COVID-19 infection: a case report","volume":"13","author":"M Kajita","year":"2022","journal-title":"Surg Neurol Int"},{"issue":"02","key":"ref6","doi-asserted-by":"crossref","first-page":"105429","DOI":"10.1016\/j.jstrokecerebrovasdis.2020.105429","article-title":"Acute cerebrovascular disorders and vasculopathies associated with significant mortality in SARS-CoV-2 patients admitted to the intensive care unit in the New York epicenter","volume":"30","author":"F Al-Mufti","year":"2021","journal-title":"J Stroke Cerebrovasc Dis"},{"issue":"01","key":"ref7","doi-asserted-by":"crossref","first-page":"17","DOI":"10.3171\/2020.5.JNS201542","article-title":"Cerebral deep venous thrombosis and COVID-19: case report","volume":"135","author":"C Hoelscher","year":"2020","journal-title":"J Neurosurg"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.wneu.2015.08.052","article-title":"Risk factors for cerebral vasospasm following aneurysmal subarachnoid hemorrhage: a review of the literature","volume":"85","author":"T Inagawa","year":"2016","journal-title":"World Neurosurg"},{"issue":"06","key":"ref9","doi-asserted-by":"crossref","first-page":"e13782","DOI":"10.1111\/eci.13782","article-title":"The end of the COVID-19 pandemic","volume":"52","author":"J PA Ioannidis","year":"2022","journal-title":"Eur J Clin Invest"},{"issue":"08","key":"ref10","doi-asserted-by":"crossref","first-page":"e0236776","DOI":"10.1371\/journal.pone.0236776","article-title":"Change in global transmission rates of COVID-19 through May 6 2020","volume":"15","author":"E O Romero-Severson","year":"2020","journal-title":"PLoS One"},{"issue":"03","key":"ref11","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1002\/path.5471","article-title":"Angiotensin-converting enzyme 2 (ACE2), SARS-CoV-2 and the pathophysiology of coronavirus disease 2019 (COVID-19)","volume":"251","author":"A R Bourgonje","year":"2020","journal-title":"J Pathol"},{"issue":"06","key":"ref12","doi-asserted-by":"crossref","first-page":"1222","DOI":"10.1016\/j.mayocp.2020.03.026","article-title":"Angiotensin-converting enzyme 2 and antihypertensives (angiotensin receptor blockers and angiotensin-converting enzyme inhibitors) in coronavirus disease 2019","volume":"95","author":"F Sanchis-Gomar","year":"2020","journal-title":"Mayo Clin Proc"},{"issue":"02","key":"ref13","doi-asserted-by":"crossref","first-page":"106904","DOI":"10.1016\/j.jstrokecerebrovasdis.2022.106904","article-title":"Characteristics of subarachnoid hemorrhage associated with COVID-19 infection: a systematic review and descriptive analysis","volume":"32","author":"M JR Lim","year":"2023","journal-title":"J Stroke Cerebrovasc Dis"},{"issue":"02","key":"ref14","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1055\/s-0043-1777055","article-title":"Ruptured cerebral aneurysms and dissecting aneurysms in patients with COVID-19: a case series and literature review","volume":"13","author":"D Wajima","year":"2024","journal-title":"Indian J Neurosurg"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1093\/brain\/124.2.249","article-title":"Subarachnoid haemorrhage: diagnosis, causes and management","volume":"124","author":"J van Gijn","year":"2001","journal-title":"Brain"},{"issue":"05","key":"ref16","doi-asserted-by":"crossref","first-page":"712","DOI":"10.3171\/jns.2001.94.5.0712","article-title":"Pathological mechanism and three-dimensional structure of cerebral dissecting aneurysms","volume":"94","author":"T Mizutani","year":"2001","journal-title":"J Neurosurg"},{"issue":"03","key":"ref17","doi-asserted-by":"crossref","first-page":"663","DOI":"10.3171\/2014.10.JNS14175","article-title":"Spontaneous subarachnoid hemorrhage of unknown origin: hospital course and long-term clinical and angiographic follow-up","volume":"122","author":"A M Elhadi","year":"2015","journal-title":"J Neurosurg"}],"container-title":["Asian Journal of Neurosurgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0045-1811244.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T00:01:49Z","timestamp":1764720109000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0045-1811244"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,8]]},"references-count":17,"journal-issue":{"issue":"04","published-online":{"date-parts":[[2025,12,2]]},"published-print":{"date-parts":[[2025,12]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0045-1811244","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["1793-5482","2248-9614"],"issn-type":[{"type":"print","value":"1793-5482"},{"type":"electronic","value":"2248-9614"}],"subject":[],"published":{"date-parts":[[2025,9,8]]}}}