Hospital Universitário Walter Cantídio, Universidade Federal do Ceará, Fortaleza, Brazil.
Department of Clinical Medicine, Neurology Section, Universidade Federal do Ceará, Fortaleza, Brazil.
BMC Infect Dis. 2022 Mar 3;22(1):216. doi: 10.1186/s12879-022-07184-x.
COVID-19 is a pandemic disease responsible for many deaths worldwide. Many neurological manifestations have been described. We report a case of normal pressure hydrocephalus (NPH) 2 months after acute COVID19 infection, in a patient without other risk factors.
A 45-year-old male patient presented an 8-month history of progressive gait disorder and cognitive impairment after being hospitalized for SARS-CoV-2 infection. Magnetic resonance imaging (MRI) was compatible with NPH. A spinal tap test was positive and there was progressive improvement after shunting, with complete resolution of symptoms.
Other infections such as syphilis, cryptococcosis and Lyme disease have been associated with NPH. Possible mechanisms for NPH after COVID include disruption of choroid plexus cells by direct viral invasion or as a result of neuroinflammation and cytokine release and hypercoagulability leading to venous congestion and abnormalities of CSF flow. Given the significance of NPH as a cause of reversible dementia, it is important to consider the possibility of a causal association with COVID19 and understand the mechanisms behind this association.
COVID-19 是一种在全球范围内导致许多人死亡的大流行病。已经描述了许多神经表现。我们报告了一例急性 COVID-19 感染后 2 个月发生的正常压力脑积水（NPH），患者无其他危险因素。
一名 45 岁男性患者因 SARS-CoV-2 感染住院后出现 8 个月的进行性步态障碍和认知障碍。磁共振成像（MRI）与 NPH 相符。腰椎穿刺试验阳性，分流后逐渐改善，症状完全缓解。
其他感染，如梅毒、隐球菌病和莱姆病，与 NPH 有关。COVID 后发生 NPH 的可能机制包括直接病毒入侵或神经炎症和细胞因子释放导致脉络丛细胞破坏以及高凝导致静脉充血和 CSF 流异常。鉴于 NPH 是可逆性痴呆的一个重要原因，因此必须考虑与 COVID-19 之间可能存在因果关系，并了解这种关联背后的机制。
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