Case Report/Case SeriesTectal Hemorrhage in the Setting of COVID-19 InfectionO’Brien, Patrick F. MD; Johnson, Erica C. BS; Graham, Robert S. MD Author Information Department of Neurosurgery, Virginia Commonwealth University Health System, Richmond, VA The authors declare no conflict of interest. Correspondence to: Patrick F. O’Brien, MD, Department of Neurosurgery, Virginia Commonwealth University School of Medicine, 417 North 11th Street, Sixth Floor, Box 980631, Richmond, VA 23298. E-mail: [email protected]. The Neurologist: May 2022 - Volume 27 - Issue 3 - p 151-154 doi: 10.1097/NRL.0000000000000427 Buy Metrics Abstract Introduction: Coronavirus disease 2019 (COVID-19) has emerging evidence of a relationship to intracranial hemorrhage. The hemorrhages described to date often affect patients on anticoagulation, of advanced age, of nonwhite race, and requiring mechanical ventilation. Unusual or rare hemorrhage patterns have not as yet been described in the literature as being associated with COVID-19. Case Report: A 36-year-old Hispanic male with no significant past medical history presented with isolated tectal intraparenchymal hemorrhage with intraventricular hemorrhage in the setting of no identifiable risk factors other than COVID-19. His management required temporizing with external ventricular drainage and subsequent endoscopic third ventriculostomy for ongoing obstruction of the cerebral aqueduct following the hemorrhage. He was discharged and did clinically well. To our knowledge, this is the first report of an intraparenchymal hematoma of the brain isolated to the midbrain tectum with only COVID-19 as a risk factor. Conclusion: COVID-19 may predispose patients to rare types of intraparenchymal hematomas which remain amenable to standard management algorithms. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.