Rhabdomyolysis following interventional therapy for patients with ruptured intracranial aneurysm complicated by COVID-19:a case report

CAO Wenyan; LI Yuping; LIU Xiaoguang

doi:10.13798/j.issn.1009-153X.2025.09.013

Abstract：Rhabdomyolysis is a common condition,often presenting with acute muscle weakness,muscle pain or swelling,and dark-colored urine.However,its symptoms can be relatively insidious in patients with impaired consciousness.Concurrently,acute kidney injury(AKI)associated with rhabdomyolysis has a high mortality rate.This article reports a case of rhabdomyolysis following interventional therapy in a 58-year-old female with a ruptured intracranial aneurysm associated with COVID-19.The patient was admitted due to sudden headache,vomiting,and impaired consciousness for 2 days.Digital subtrac-tion angiography(DSA)diagnosed a ruptured anterior communicating artery aneurysm with subarachnoid hemorrhage,and coil embolization was performed.The patient remained comatose postoperatively and tested positive for COVID-19.Elevated serum creatine kinase led to a consideration of rhabdomyolysis,and treatment with fluid resuscitation and urine alkalinization was initi-ated.However,serum creatinine and blood urea nitrogen progressively increased,accompanied by anuria,leading to a diagnosis of severe rhabdomyolysis complicated by AKI.Continuous renal replacement therapy(CRRT)was immediately administered for 7 days.Subsequently,renal function gradually improved,24-hour urine output recovered,and serum CK and myoglobin lev-els gradually decreased.At the 3-month follow-up after discharge,serum CK and myoglobin had returned to normal.This case suggests that patients with ruptured intracranial aneurysms undergoing multiple surgical procedures within a short period and complicated by viral infection fit the profile of a high-risk population for rhabdomyolysis,warranting clinical vigilance.Early detection and timely treatment of rhabdomyolysis-associated AKI are crucial.