Severe Covid 19 Pneumonia and Neurological Disorders in A Field Hospital: Benefit of Bedside Ultrasound

Introduction: The Covid 19 is multisystem disease, with a cerebro-vascular manifestation including, ischemic, embolic and hemorragique strocke. Case Report: Patient is 80 years old, with a history of chronic smoking that has been stopped for 30 years and ischemic heart disease. Presenting for a fortnight a cough with fever and myalgia and dyspnea. A thoracic tomodensitometry had objectified an aspect of Covid 19 pneumonia with more than 75% of the pulmonary parenchyma, and a PCR SARS-COV 2 performed on a positive nasopharyngeal sample. He admitted to intensive care unit because he had a respiratory distress with high oxygen flow. The evolution during the first 24 hours of hospitalisation was one of respiratory aggravation, followed on the second day by the installation of a predominantly brachial left hemiparesis, without pupillary anomaly. A cerebral ultrasound scan revealed a hyperchoic image in the cerebral parenchyma suggesting intracerebral hemorrhage, without any image of midline deviation, with a normal Doppler study. The patient had worsened respiratory distress requiring mechanical ventilation with protective ventilation by trying to keep a PaCO2 close to normal and stopping anticoagulation for one week. The result was unfavourable with death on the ninth day of admission.