SARS-CoV-2 infection has been associated with ischemic stroke as well as systemic complications such as acute respiratory failure; cytotoxic edema is a well-known sequelae of acute ischemic stroke and can be worsened by the presence of hypercarbia induced by respiratory failure. We present the case of a very rapid neurologic and radiographic decline of a patient with an acute ischemic stroke who developed rapid fulminant cerebral edema leading to herniation in the setting of hypercarbic respiratory failure attributed to SARS-CoV-2 infection. Given the elevated incidence of cerebrovascular complications in patients with COVID-19, it is imperative for clinicians to be aware of the risk of rapidly progressive cerebral edema in patients who develop COVID-19 associated acute respiratory distress syndrome.

SARS-CoV-2感染与缺血性中风以及全身性并发症（例如急性呼吸衰竭）有关；细胞毒性水肿是急性缺血性卒中的众所周知的后遗症，并可能因呼吸衰竭引起的高碳酸血症而恶化。我们介绍了一个急性缺血性中风患者的快速神经系统和影像学下降的情况，该患者发展为因SARS-CoV-2感染而导致的高碳酸血症性呼吸衰竭，导致快速暴发性脑水肿导致疝。鉴于COVID-19患者脑血管并发症的发生率升高，因此临床医生必须意识到发生COVID-19相关急性呼吸窘迫综合征的患者快速进行性脑水肿的风险。