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 VOLUME Vol.05 Issue04 2025 

PAGE NO. 21-23 

DOI 10.37547/ajbspi/Volume05Issue04-05 

 
 
 
 

Neurological Complications of Covid-19: Focus on Acute 

Cerebrovascular Accidents 
 

Shodmonov Asilbek Otabekovich 

Assistant of the department of anatomy and clinical anatomy of ZARMED University, ZARMED University, Samarkand, Uzbekistan 

 

 

Received: 23 February 2025; Accepted: 19 March 2025; Published: 22 April 2025 

 

Abstract: COVID-19, typically regarded as a respiratory illness, exhibits substantial neurological involvement, 
especially in severely affected patients. Acute cerebrovascular events, including ischemic and hemorrhagic 
strokes, are seen in relatively young, previously healthy individuals, linked to hypercoagulability and 
prothrombotic states. Neurological complications of COVID-19 may arise without direct central nervous system 
infection, stemming from a severe systemic reaction to the infection. Further research into the pathophysiology 
and clinical trials are needed to optimize strategies preventing long-term consequences and therapeutic choices. 

 

Keywords: COVID-19; SARS-CoV-2; neurological complications; acute cerebrovascular accident; ischemic stroke; 
cerebral haemorrhage; cerebral vein thrombosis; hypercoagulability; thrombosis. 

 

Introduction: Ischemic stroke remains one of the 
leading causes of death and disability worldwide. 
According to the Global Burden of Disease study, the 
total number of disability-adjusted life years (DALYs) 
due to stroke reached 143 million in 2019. Given the 
aging population and the increasing number of risk 
factors, the issue of long-term neurological and 
functional consequences of stroke is becoming 
increasingly important. Despite advances in acute 
therapy, such as extending the time frame for 
endovascular thrombectomy to 24 hours in selected 
cases, the need for a thorough understanding and 
effective management of late consequences remains a 
key challenge in modern neurology and rehabilitation. 

METHODS 

A systematic review of the literature on the topics of 
remote neurological consequences of ischemic stroke 
was conducted, including epidemiological studies, 
longitudinal cognitive and neuropsychological studies, 

data from child and adult cohorts, as well as 
international clinical guidelines of AHA/ASA, ESO and 
NICE. Inclusion criteria: publications for 2000–2023, 
English- and Russian-language articles, results of 
randomized controlled trials, cohort studies and 
guidelines. The search was performed in the PubMed, 
Scopus and eLibrary databases. 

RESULTS 

In 2019, the number of DALYs due to stroke was 143 
million. Stroke remains the second leading cause of 
death and the third leading cause of disability 
worldwide. 

Prospective study data showed that dementia affects 
up to 20% of patients in the acute phase and up to 39% 
of survivors one year after stroke. A study by 
Mehrabian et al. found that hippocampal atrophy is the 
strongest predictor of late post-stroke cognitive 
dysfunction. 

Table 1 

Prevalence of cognitive and neurological outcomes after ischemic stroke 

Outcome Group Frequency 

Dementia 1 year after stroke Adults 39% 

Moderate and severe neurological impairment 2 years later Children 9,4% 

 

https://doi.org/10.37547/ajbspi/Volume05Issue04-05
https://doi.org/10.37547/ajbspi/Volume05Issue04-05
https://doi.org/10.37547/ajbspi/Volume05Issue04-05
https://doi.org/10.37547/ajbspi/Volume05Issue04-05


American Journal of Applied Science and Technology 22 https://theusajournals.com/index.php/ajast 

American Journal of Applied Science and Technology (ISSN: 2771-2745) 
 

 

Incidence of recurrent MI/TIA in children Children 19% 

Movement disorders and post-stroke pain significantly 
affect the quality of life and require a comprehensive 
multidisciplinary approach to rehabilitation. 
Psychoemotional complications, such as depression 
and anxiety disorders, are observed in a significant 

proportion of patients. In the United States, only 30.7% 
of stroke survivors received outpatient rehabilitation. 
In three Korean hospitals, 27.9% of patients received 
rehabilitation counseling, 12.9% were transferred to 
rehabilitation departments. 

Table 2 

Access to rehabilitation in patients after ischemic stroke 

Type of rehabilitation  Population  Percentage 

Outpatient rehabilitation Stroke Survivors 30,7% 

Rehabilitation consultation First Discharges from Three Korean 

Hospitals 

27,9% 

Transfer to the rehabilitation 

department 

First Discharges from Three Korean 

Hospitals 

12,9% 

DISCUSSION 

The results of the review confirm a significant level of 
cognitive and neurological impairment in the late 
period after ischemic stroke in adults and children. The 
high incidence of dementia and motor deficits 
emphasizes the importance of early risk identification 
and development of effective rehabilitation strategies. 
Despite the proven benefits of extended 
thrombectomy and telestroke networks for delivery of 
acute care, many patients face limited access to 

rehabilitation services. 

The 2018 AHA/ASA Guidelines, partially revised and 
supplemented after the removal of a number of 
sections, emphasize the need for an individualized 
approach and multifactorial outcome assessment. 
International ESO and NICE guidelines also focus on 
continuous rehabilitation and monitoring of cognitive 
status. 

  

 

Scheme 1. Pathogenetic stages of development and remote outcomes of ischemic stroke 

  

Acute phase of 
stroke

Cerebral 
ischemia: nucleus 

and penumbra

Neuropsychologi
cal consequences

Cognitive 
impairment and 

dementia

Post-stroke pain 
and emotional 

disorders

Functional 
independence 

and quality of life

Motor and 
sensory deficits

Rehabilitation 
and access to 

care



American Journal of Applied Science and Technology 23 https://theusajournals.com/index.php/ajast 

American Journal of Applied Science and Technology (ISSN: 2771-2745) 
 

 

CONCLUSION 

Stroke remains the leading cause of DALYs worldwide. 
Dementia occurs in 39% of survivors one year after 
stroke. In children, 9.4% have moderate to severe 
neurological impairment at two years; recurrent 
MI/TIA reaches 19%. Only 27.9% of patients receive 
rehabilitation consultations and 12.9% are transferred  

to rehabilitation units during their first hospitalization; 
30.7% of survivors receive outpatient rehabilitation. 

Extension of the time frame of endovascular  
thrombectomy to 24 hours has improved access to 
acute therapy. Further research should be aimed at 
improving the quality and availability of rehabilitation, 
developing personalized neuroprotection programs 
and introducing modern technologies for monitoring 
and supporting patients in the late period after stroke. 

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