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Cerebral microvascular injuries in severe COVID-19 infection: progression of white matter hyperintensities post-infection

A range of neuroradiological findings has been reported in patients with COVID-19, some mimicking cerebral small vessel disease (CSVD). We present a case of a man in his 50s with severe COVID-19, who was Glasgow Coma Scale 3 and tetraparetic after sedation was ceased in the intensive care unit. Retu...

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Autores principales: Petersson, Ida, Hansen, Bjorn M, Svenningsson, Anders, Lundstrom, Annika
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9472107/
https://www.ncbi.nlm.nih.gov/pubmed/36100286
http://dx.doi.org/10.1136/bcr-2022-249156
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author Petersson, Ida
Hansen, Bjorn M
Svenningsson, Anders
Lundstrom, Annika
author_facet Petersson, Ida
Hansen, Bjorn M
Svenningsson, Anders
Lundstrom, Annika
author_sort Petersson, Ida
collection PubMed
description A range of neuroradiological findings has been reported in patients with COVID-19, some mimicking cerebral small vessel disease (CSVD). We present a case of a man in his 50s with severe COVID-19, who was Glasgow Coma Scale 3 and tetraparetic after sedation was ceased in the intensive care unit. Return of consciousness and motor activity was slow. An MRI 1 month after debut of symptoms demonstrated white matter hyperintensities on T2-weighted Fluid Attenuated Inversion Recovery (T2-FLAIR) and many small areas with impaired diffusion in primarily supratentorial and infratentorial white matter on Diffusion-Weighted Imaging (DWI). In the following months, the patient made a remarkable clinical recovery. Despite clinical improvement, an MRI after 7 months showed that white matter hyperintensities had progressed and become confluent. Both MRIs demonstrated findings resembling CSVD, which could relate to a COVID-19-specific process affecting cerebral microvasculature.
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spelling pubmed-94721072022-09-15 Cerebral microvascular injuries in severe COVID-19 infection: progression of white matter hyperintensities post-infection Petersson, Ida Hansen, Bjorn M Svenningsson, Anders Lundstrom, Annika BMJ Case Rep Case Reports: Findings that shed new light on the possible pathogenesis of a disease A range of neuroradiological findings has been reported in patients with COVID-19, some mimicking cerebral small vessel disease (CSVD). We present a case of a man in his 50s with severe COVID-19, who was Glasgow Coma Scale 3 and tetraparetic after sedation was ceased in the intensive care unit. Return of consciousness and motor activity was slow. An MRI 1 month after debut of symptoms demonstrated white matter hyperintensities on T2-weighted Fluid Attenuated Inversion Recovery (T2-FLAIR) and many small areas with impaired diffusion in primarily supratentorial and infratentorial white matter on Diffusion-Weighted Imaging (DWI). In the following months, the patient made a remarkable clinical recovery. Despite clinical improvement, an MRI after 7 months showed that white matter hyperintensities had progressed and become confluent. Both MRIs demonstrated findings resembling CSVD, which could relate to a COVID-19-specific process affecting cerebral microvasculature. BMJ Publishing Group 2022-09-13 /pmc/articles/PMC9472107/ /pubmed/36100286 http://dx.doi.org/10.1136/bcr-2022-249156 Text en © BMJ Publishing Group Limited 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Case Reports: Findings that shed new light on the possible pathogenesis of a disease
Petersson, Ida
Hansen, Bjorn M
Svenningsson, Anders
Lundstrom, Annika
Cerebral microvascular injuries in severe COVID-19 infection: progression of white matter hyperintensities post-infection
title Cerebral microvascular injuries in severe COVID-19 infection: progression of white matter hyperintensities post-infection
title_full Cerebral microvascular injuries in severe COVID-19 infection: progression of white matter hyperintensities post-infection
title_fullStr Cerebral microvascular injuries in severe COVID-19 infection: progression of white matter hyperintensities post-infection
title_full_unstemmed Cerebral microvascular injuries in severe COVID-19 infection: progression of white matter hyperintensities post-infection
title_short Cerebral microvascular injuries in severe COVID-19 infection: progression of white matter hyperintensities post-infection
title_sort cerebral microvascular injuries in severe covid-19 infection: progression of white matter hyperintensities post-infection
topic Case Reports: Findings that shed new light on the possible pathogenesis of a disease
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9472107/
https://www.ncbi.nlm.nih.gov/pubmed/36100286
http://dx.doi.org/10.1136/bcr-2022-249156
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