一种与新型冠状病毒肺炎相关的感染后类固醇反应性脑干病变
A Post-Infectious Steroid-Responsive Brainstem Lesion Associated With COVID-19.
作者信息
Chang Philip, Tasch Edwin S, Rapoport Lisa N, Bakhadirov Khamidulla
机构信息
Department of Neurology, Kaiser Permanente Santa Clara Medical Center, Assistant Professor of Neurology, Boston University Medical School, Santa Clara, CA, USA.
Departments of Emergency Medicine and Critical Care, Kaiser Permanente Santa Clara Medical Center, Clinical Assistant Professor (Affiliate), Stanford University Department of Emergency Medicine, Santa Clara, CA, USA.
出版信息
Neurohospitalist. 2021 Apr;11(2):152-155. doi: 10.1177/1941874420959544. Epub 2020 Sep 22.
A 51-year-old man developed coma, bilateral pupillary dilation, ophthalmoplegia and quadriplegia 4 weeks after testing positive for COVID-19. MRI demonstrated a symmetric midline pontine non-enhancing T2-FLAIR hyperintense lesion. The patient was treated with intravenous methylprednisolone, which resulted in improvement of his Glasgow Coma Scale (GCS) from 3 to 15 over the next 5 days. To our knowledge, this is the first case of a post-infectious steroid-responsive brainstem lesion associated with COVID-19. The clinical picture best fits in the family of a steroid-responsive encephalopathy and reminds us that COVID-19 may cause severe post-infectious neurological complications.
一名51岁男性在COVID-19检测呈阳性4周后出现昏迷、双侧瞳孔散大、眼肌麻痹和四肢瘫痪。MRI显示脑桥中线对称的T2-FLAIR高信号无强化病灶。患者接受了静脉注射甲泼尼龙治疗，在接下来的5天里，其格拉斯哥昏迷量表（GCS）评分从3分提高到了15分。据我们所知，这是首例与COVID-19相关的感染后类固醇反应性脑干病变病例。临床表现最符合类固醇反应性脑病家族，提醒我们COVID-19可能导致严重的感染后神经并发症。
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