Clausen Thomas Mandel, Fargen Kyle M, Primiani Christopher T, Sattur Mithun, Amans Matthew R, Hui Ferdinand K
John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA.
Departments of Neurological Surgery and Radiology, Wake Forest University, Winston-Salem, NC, USA.
Interv Neuroradiol. 2024 Sep 2:15910199241273946. doi: 10.1177/15910199241273946.
Neurological long Covid (NLC) is a major post-acute sequela of SARS-CoV-2 infection, affecting up to 10% of infected patients. The clinical presentation of patients with NLC is varied, but general NLC symptoms have been noted to closely mimic symptoms of cerebral venous outflow disorders (CVD). Here we review key literature and discuss evidence supporting this comparison. We also aimed to describe the similarity between CVD symptomatology and neuro-NLC symptoms from two perspectives: a Twitter-distributed survey for long covid sufferers to estimate nature and frequency of neurological symptoms, and through a small cohort of patients with long covid who underwent CVD work up per our standard workflow. Over 700 patients responded, and we argue that there is a close symptom overlap with those of CVD. CVD workup in a series of 6 patients with neurological long COVID symptoms showed jugular vein stenosis by CT venography and varying degrees of increased intracranial pressure. Finally, we discuss the potential pathogenic association between vascular inflammation, associated with COVID-19 infection, venous outflow congestion, and its potential involvement in NLC.
神经新冠后遗症（NLC）是新冠病毒2型感染的一种主要急性后后遗症，影响高达10%的感染患者。NLC患者的临床表现各不相同，但一般的NLC症状已被注意到与脑静脉流出道疾病（CVD）的症状极为相似。在此，我们回顾关键文献并讨论支持这种比较的证据。我们还旨在从两个角度描述CVD症状学与神经NLC症状之间的相似性：通过一项在推特上向新冠长期患者开展的调查，以估计神经症状的性质和频率；以及通过一小群按照我们的标准流程接受CVD检查的新冠长期患者进行描述。700多名患者做出了回应，我们认为这些症状与CVD症状有密切重叠。对一系列6名有神经新冠长期症状的患者进行的CVD检查显示，CT静脉造影显示颈静脉狭窄，颅内压有不同程度升高。最后，我们讨论了与新冠病毒感染相关的血管炎症、静脉流出道充血及其在NLC中的潜在作用之间的潜在致病关联。
