Covid-19–associated diffuse posthypoxic leukoencephalopathy and microhemorrhages – A case report

BACKGROUND: Delayed post-hypoxic leukoencephalopathy (DPHL) with associated microbleeds is a clinical entity presenting with cognitive impairment days or weeks after an episode of acute hypoxic brain injury. CASE REPORT: We describe a 68-year-old male with SARS-CoV2 infection who had cardiac arrest, required sedation and mechanical ventilation for 17 days, and after sedation was discontinued, he became unresponsive. Brain MRI showed diffuse confluent hyperintense signals in the subcortical white matter and multiple subcortical white matter microhemorrhages. EEG revealed diffuse attenuation of brain electrical activity with isolated polymorphic delta waves in the frontal region without epileptiform activity. CONCLUSIONS: Clinicians need to be aware that patients with Covid-19 can develop delayed post-hypoxic leukoencephalopathy.