Department of Diagnostic and Interventional Neuroradiology, Ospedale Policlinico San Martino, IRCCS, Genoa, Italy.
Anesthesia and Intensive Care Unit, Ospedale Policlinico San Martino, IRCCS for Oncology and Neuroscience, Genoa, Italy.
Neurol Sci. 2020 Dec;41(12):3401-3404. doi: 10.1007/s10072-020-04795-7. Epub 2020 Oct 9.
We describe the case of a COVID-19 patient with severely impaired consciousness after sedation hold, showing magnetic resonance imaging (MRI) findings of (i) acute bilateral supratentorial ischemic lesions involving the fronto-parietal white matter and the corpus callosum and (ii) multiple diffuse susceptibility weighted imaging (SWI) hypointense foci, infra and supratentorial, predominantly bithalamic, suggestive of microhemorrhage or alternatively microthrombi. Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) RNA was detected in the cerebrospinal fluid. Our findings suggest the occurrence of vascular damage, predominantly involving microvessels. The underlying mechanisms, which include direct and indirect penetration of the virus to the central nervous system and systemic cardiorespiratory complications, are yet to be elucidated, and a direct correlation with SARS-CoV-2 infection remains uncertain.
我们描述了一例 COVID-19 患者在镇静后意识严重受损，其磁共振成像（MRI）结果显示（i）急性双侧额顶叶白质和胼胝体缺血性病变，以及（ii）多个弥漫性磁敏感加权成像（SWI）低信号病灶，位于幕上和幕下，主要为双侧丘脑，提示微出血或微血栓形成。在脑脊液中检测到严重急性呼吸综合征冠状病毒-2（SARS-CoV-2）RNA。我们的发现表明血管损伤的发生，主要涉及微血管。其潜在机制包括病毒直接和间接穿透中枢神经系统以及全身心肺并发症，尚未阐明，与 SARS-CoV-2 感染的直接相关性仍不确定。
