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COVID-19 感染后合并脑静脉血栓形成的 MRI 阴性脊髓炎。

MRI-negative myelitis associated with cerebral venous thrombosis after COVID-19 infection.

机构信息

Department of Neurology, Al-Mouwasat Hospital, Damascus, Syrian Arab Republic.

Primary Health Care Corporation, Doha, Qatar.

出版信息

BMJ Case Rep. 2022 Oct 28;15(10):e250535. doi: 10.1136/bcr-2022-250535.

Abstract

Transverse myelitis and cerebral venous thrombosis represent some of the described neurological complications of coronavirus disease. A woman in her early 30s presented with headache, left-sided sensory symptoms and voiding difficulty. The patient also reported dry cough, fever, nasal congestion, anosmia and ageusia 2 weeks before presentation. The clinical examination showed sensory disturbances on the left side of the body, starting from the lower abdomen and extending to the left leg, which was consistent with transverse myelitis. The laboratory assessment confirmed a previous infection with coronavirus disease and excluded autoimmune entities. Radiological investigations revealed left transverse sinus thrombosis with no spinal cord abnormalities. The treatment was started with therapeutic anticoagulation and intravenous high-dose steroids. The patient showed significant improvement, and the neurological deficits resolved after 3 months. This is the first documented case of imaging-negative myelitis associated with cerebral venous thrombosis after coronavirus disease.

摘要

横贯性脊髓炎和脑静脉血栓形成是冠状病毒病所描述的一些神经系统并发症。一位 30 多岁的女性因头痛、左侧感觉症状和排尿困难就诊。患者还报告在就诊前 2 周出现干咳、发热、鼻塞、嗅觉丧失和味觉丧失。临床检查显示身体左侧感觉障碍,从下腹部开始延伸至左腿,符合横贯性脊髓炎的表现。实验室评估证实先前感染过冠状病毒病,排除了自身免疫性疾病。影像学检查显示左侧横窦血栓形成,脊髓无异常。治疗开始采用抗凝治疗和静脉内大剂量类固醇。患者病情显著改善,3 个月后神经功能缺损得到解决。这是首例冠状病毒病后并发脑静脉血栓形成且脊髓影像学阴性的病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d0a1/9621158/bd959713344e/bcr-2022-250535f01.jpg

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