Department of Neurology, University of Missouri Health Care, Columbia, MO, USA.
Department of Neuroradiology, University of Missouri, Columbia, MO, USA.
Am J Case Rep. 2022 May 24;23:e934955. doi: 10.12659/AJCR.934955.
BACKGROUND The SARS-CoV-2 viral infection is associated with respiratory and multi-organ systemic disease. It has been shown to affect the central nervous system and produce varied neurological symptoms, including ischemic strokes, seizures, and encephalitis. Neurological manifestations of this viral infection are thought to be due to neurotropic reactions on the central nervous system or post-infectious immune-mediated damage. This report presents a case of bilateral tremor of the upper limbs more than 6 weeks after a diagnosis of COVID-19, with confirmed volumetric brain loss shown by follow-up brain magnetic resonance imaging (MRI) combined with 3-dimensional volumetric NeuroQuant image analysis. CASE REPORT We report a case of new-onset tremors in a 62-year-old man after SARS-CoV-2 infection. MRI of the brain was performed shortly after the onset of tremors, and a follow-up MRI after 2 months showed evidence of rapid parenchymal volume, loss of midbrain substance, and increased cerebrospinal fluid volume within 2 months of the initial examination. CONCLUSIONS This case report shows central neurological effects of COVID-19, which can be evaluated by quantitative volumetric MRI analysis, although further studies are warranted to determine how this type of brain imaging can be used to evaluate the effects of SARS-CoV-2 infection over time.
SARS-CoV-2 病毒感染与呼吸道和多器官系统疾病有关。已证实它会影响中枢神经系统并产生多种神经系统症状，包括缺血性中风、癫痫发作和脑炎。这种病毒感染的神经系统表现被认为是由于中枢神经系统的嗜神经性反应或感染后免疫介导的损伤。本报告介绍了一例 COVID-19 诊断后超过 6 周出现双侧上肢震颤的病例，通过后续脑磁共振成像（MRI）结合 3 维容积神经定量图像分析证实存在脑容积丢失。
我们报告了一例 62 岁男性 SARS-CoV-2 感染后新发震颤。震颤发作后不久即进行了脑部 MRI，2 个月后的随访 MRI 显示，在初始检查后的 2 个月内，脑实质体积迅速丢失、中脑实质减少、脑脊液体积增加。
本病例报告显示了 COVID-19 的中枢神经系统影响，可以通过定量容积 MRI 分析进行评估，尽管需要进一步研究来确定这种类型的脑成像如何随时间推移来评估 SARS-CoV-2 感染的影响。
