COVID-19 associated acute demyelination masquerading as stroke: a case report

Krati Khandelwal1, Monika Puranik1, V. Gupta1, Gaurav Khandelwal2, Pranav Kumar Dave1, Makarand Hirve3
1Department of Radiology, LN Medical College and JK Hospital, Bhopal, India
2Department of Cardiology, All India Institute of Medical Sciences, Bhopal, India
3Department of Neurology, LN Medical College and JK Hospital, Bhopal, India

Tóm tắt

AbstractBackgroundDuring the recent outbreak of COVID-19, various atypical extrapulmonary manifestations are being seen, including neurological ones. Reported cases mainly include encephalopathy, myelitis, and cranial nerve involvement. This case describes uncommon neuroradiological finding in the context of COVID-19.Case presentationWe report an atypical case of COVID-19 presenting with stroke-like episode, with MRI brain showing isolated bilateral posterior internal capsule involvement. This has rarely been reported in literature.ConclusionAs the numbers of COVID-19 cases are increasing, such atypical presentations should be kept in mind.

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Tài liệu tham khảo

Maramottom BV, Bhattacharjee S (2020) Neurological complications with COVID-19: a contemporaneous review. Ann Indian Acad Neurol 23:468–476

Poyiadji N, Shahin G, Noujaim D et al (2020) COVID-19–associated acute hemorrhagic necrotizing encephalopathy: CT and MRI features. Radiology 296:E119–E120

Moriguchi T, Harii N, Goto J et al (2020) A first case of meningitis/encephalitis associated with SARS-Coronavirus-2. Int J Infect Dis 94:55–58

Ye M, Ren Y, Lv T (2020) Encephalitis as a clinical manifestation of COVID-19. Brain Behav Immun 88:945–946

Kremer S, Lersy F, Seze D et al (2020) Brain MRI findings in Severe COVID-19: A Retrospective Observational Study. Radiology 297:E242–E251. https://doi.org/10.1148/radiol.202020222

Valiuddin H, Skwirsk B, Paz-Arabo P (2020) Acute transverse myelitis associated with SARS-CoV-2: a case-report. Brain Behav Immun Health 5:100091. https://doi.org/10.1016/j.bbih.2020.100091

Sarma D, Bilello L (2020) A Case Report of Acute Transverse Myelitis Following Novel Coronavirus Infection. Clin Pract Cases Emerg Med 4(3):321–323

Bohmwald K, Galvez NMS, Rios M, Kalergis AM (2018) Neurologic alterations due to respiratory virus infections. Front Cell Neurosci 12:386. https://doi.org/10.3389/fncel.2018.00386

Desforges M, Le Coupanec A, Stodola JK, Meessen-Pinard M, Talbot PJ (2014) Human coronaviruses: viral and cellular factors involved in neuroinvasiveness and neuropathogenesis. Virus Res 194:145–158. https://doi.org/10.1016/j.virusres.2014.09.011

Kihira S, Delman BN, Belani P, Stein L, Aggarwal B et al (2020) Imaging features of acute encephalopathy in patients with COVID-19: a case series. Am J Neuroradiol 41:1804–1808. https://doi.org/10.3174/ajnr.A6715

Zoghi A, Ramezani M, Roozbeh M, Darazam IA, Sahraian MA (2020) A case of possible atypical demyelinating event of the central nervous system following COVID-19. Mult Scler Relat Disord 44:102324. https://doi.org/10.1016/j.msard.2020.102324