Department Radiology, Fortis Escorts Heart Institute & Research Centre, New Delhi, Delhi 110025, India.
Curr Med Imaging. 2022;19(1):91-95. doi: 10.2174/1573405618666220509205457.
A 67-year-old female with no significant past medical history presented to the critical care department with symptoms of encephalopathy.
The patient's Main Concerns and the Important Clinical Findings: The patient had a history of COVID -19 vaccination (recombinant ChAdOX1 nCoV-19) 14 days prior to the symptoms. She underwent an MRI of the brain and cervical spine and a lumbar puncture. The Primary Diagnoses, Interventions, and Outcomes: The patient was examined and sent for an MRI of the brain and cervical spine, followed by extensive blood and CSF investigations to rule out any infective, paraneoplastic, connective tissue disorder, or inflammatory disorder. The patient was given steroids, and a good response was reported. The primary diagnosis was made as vaccine-induced ADEM.
The clinical exam, location, sparse contrast enhancement, and CSF findings were all consistent with an acute demyelinating event, and the history of vaccination, together with the clinical situation, was found to be favourable for the development of acute disseminated encephalomyelitis.
一位 67 岁的女性,无明显既往病史,因脑病症状就诊于重症监护病房。
患者的主要关注点和重要临床发现:患者在出现症状前 14 天接种过 COVID-19 疫苗(重组 ChAdOX1 nCoV-19)。她接受了脑部和颈部 MRI 以及腰椎穿刺检查。
主要诊断、干预措施和结果:患者接受了检查并进行了脑部和颈部 MRI,随后进行了广泛的血液和 CSF 检查以排除任何感染性、副肿瘤性、结缔组织疾病或炎症性疾病。给予患者类固醇治疗,报告称反应良好。最终诊断为疫苗诱导的急性播散性脑脊髓炎。
临床检查、病变位置、稀疏的对比增强以及 CSF 检查结果均符合急性脱髓鞘事件,且疫苗接种史结合临床情况,有利于急性播散性脑脊髓炎的发生。