Severe and persistent coronavirus disease 2019 cough resulting in bone flap displacement and pseudomeningocele

Pascual, Juan Silvestre Grecia; Chan, Kevin Ivan Peñaverde; Khu, Kathleen Joy Ong-Lopez

BACKGROUND: Cough is one of the most common symptoms of coronavirus disease 2019 (COVID-19) infection. This relatively benign symptom may lead to serious sequelae, especially in postoperative neurosurgical patients. CASE DESCRIPTION: Here, we report a case of bone flap displacement, pseudomeningocele formation, and consequent cerebrospinal fluid leak in a patient with COVID-19 infection who recently underwent craniotomy for excision of cerebral metastasis. We highlight the pathophysiologic mechanisms of cough that may cause increased intracranial pressure (ICP), leading to the postoperative morbidity. CONCLUSION: Aside from additional risks to the patient’s health and increased treatment costs, these complications also lead to subsequent delays in the management of the underlying disease. Symptomatic treatment of cough is advised to prevent complications resulting from increased ICP.