Cargando…
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...
Autores principales: | , , , |
---|---|
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 |
_version_ | 1784789234936184832 |
---|---|
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. |
format | Online Article Text |
id | pubmed-9472107 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
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 |
work_keys_str_mv | AT peterssonida cerebralmicrovascularinjuriesinseverecovid19infectionprogressionofwhitematterhyperintensitiespostinfection AT hansenbjornm cerebralmicrovascularinjuriesinseverecovid19infectionprogressionofwhitematterhyperintensitiespostinfection AT svenningssonanders cerebralmicrovascularinjuriesinseverecovid19infectionprogressionofwhitematterhyperintensitiespostinfection AT lundstromannika cerebralmicrovascularinjuriesinseverecovid19infectionprogressionofwhitematterhyperintensitiespostinfection |