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Cytotoxic lesion of the corpus callosum as presenting neuroradiological manifestation of COVID-2019 infection
Forestier, Géraud; de Beaurepaire, Isaure; Bornet, Grégoire ...
Journal of neurology,
05/2021, Letnik:
268, Številka:
5
Journal Article
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Odprti dostop
Author Affiliation: (1) Neuroradiology Department, University Hospital of Limoges, Dupuytren, 2 avenue Martin Luther King, 87042, Limoges Cedex, France (2) Radiology Department, Hopital Prive ...
d'Antony, 25 Avenue de la Providence, 92160, Antony, France (3) Neuroradiology Department, INSERM U1266, Universite de Paris, Sainte-Anne Hospital, Paris, France (a) geraudforestier@gmail.com Article History: Registration Date: 08/12/2020 Received Date: 05/15/2020 Accepted Date: 08/12/2020 Online Date: 08/18/2020 Byline:
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Brain MRI Findings in Severe COVID-19: A Retrospective Observational Study
Kremer, Stéphane; Lersy, François; de Sèze, Jérome ...
Radiology,
11/2020, Letnik:
297, Številka:
2
Journal Article
Recenzirano
Odprti dostop
Background Brain MRI parenchymal signal abnormalities have been associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Purpose To describe the neuroimaging findings (excluding ...
ischemic infarcts) in patients with severe coronavirus disease 2019 (COVID-19) infection. Materials and Methods This was a retrospective study of patients evaluated from March 23, 2020, to April 27, 2020, at 16 hospitals. Inclusion criteria were (
) positive nasopharyngeal or lower respiratory tract reverse transcriptase polymerase chain reaction assays, (
) severe COVID-19 infection defined as a requirement for hospitalization and oxygen therapy, (
) neurologic manifestations, and (
) abnormal brain MRI findings. Exclusion criteria were patients with missing or noncontributory data regarding brain MRI or brain MRI showing ischemic infarcts, cerebral venous thrombosis, or chronic lesions unrelated to the current event. Categorical data were compared using the Fisher exact test. Quantitative data were compared using the Student
test or Wilcoxon test.
< .05 represented a significant difference. Results Thirty men (81%) and seven women (19%) met the inclusion criteria, with a mean age of 61 years ± 12 (standard deviation) (age range, 8-78 years). The most common neurologic manifestations were alteration of consciousness (27 of 37, 73%), abnormal wakefulness when sedation was stopped (15 of 37, 41%), confusion (12 of 37, 32%), and agitation (seven of 37, 19%). The most frequent MRI findings were signal abnormalities located in the medial temporal lobe in 16 of 37 patients (43%; 95% confidence interval CI: 27%, 59%), nonconfluent multifocal white matter hyperintense lesions seen with fluid-attenuated inversion recovery and diffusion-weighted sequences with variable enhancement, with associated hemorrhagic lesions in 11 of 37 patients (30%; 95% CI: 15%, 45%), and extensive and isolated white matter microhemorrhages in nine of 37 patients (24%; 95% CI: 10%, 38%). A majority of patients (20 of 37, 54%) had intracerebral hemorrhagic lesions with a more severe clinical presentation and a higher admission rate in intensive care units (20 of 20 patients 100% vs 12 of 17 patients without hemorrhage 71%,
= .01) and development of the acute respiratory distress syndrome (20 of 20 patients 100% vs 11 of 17 patients 65%,
= .005). Only one patient had SARS-CoV-2 RNA in the cerebrospinal fluid. Conclusion Patients with severe coronavirus disease 2019 and without ischemic infarcts had a wide range of neurologic manifestations that were associated with abnormal brain MRI scans. Eight distinctive neuroradiologic patterns were described. © RSNA, 2020.
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