Wan Chenyi, Li Menghua, Yu Yanyan, Luo Si, Hong Daojun, Zhou Meihong, Zhu Yu
Department of Neurology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China.
Rare Disease Center, the First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China.
Brain Behav. 2025 Jun;15(6):e70547. doi: 10.1002/brb3.70547.
Cytotoxic lesions of the corpus callosum (CLOCCs) are a rare clinicoradiologic syndrome, exceptionally rare in association with coronavirus disease (COVID-2019). This study aimed to investigate the neurological features of COVID-19-associated CLOCCs and gain insights into their underlying pathophysiology.
A retrospective evaluation was conducted on patients with COVID-19-associated CLOCCs admitted to our neurological diseases unit. The evaluation included comprehensive analysis of clinical presentations, laboratory findings, and radiological data.
From December 17, 2022, to December 31, 2023, our center identified CLOCCs in eight individuals with clinically established COVID-19 who underwent brain magnetic resonance imaging (MRI). The majority of patients (7/8) presented with fever preceding neurological symptoms. The spectrum of neurological findings encompassed altered consciousness (5/8), headache (4/8), cognitive and behavioral disturbances (4/8), ataxia (2/8), dysarthria (2/8), pyramidal signs (2/8), and visual impairments (2/8). Peripheral blood markers of inflammation and cytolysis revealed trends that paralleled disease progression. Elevated cerebrospinal fluid protein levels were observed in a single patient, whereas cell counts, glucose, and chloride levels were unremarkable. Treatment with glucocorticoids and antiviral medications led to complete clinical remission, with subsequent MRIs (7/8) showing radiological improvements within 3 days to 2 weeks posttreatment.
Our study shows that CLOCCs associated with COVID-19 are characterized by a favorable prognosis and distinct MRI features, similar to those observed in other clinical contexts. This underscores the importance of including CLOCCs in the differential diagnosis of COVID-19 and highlights the need for ongoing research to address the neurological condition of SARS-CoV-2 infections and to inform preventive and therapeutic strategies.
胼胝体细胞毒性病变（CLOCCs）是一种罕见的临床放射学综合征，与冠状病毒病（COVID - 2019）相关的情况极为罕见。本研究旨在调查与COVID - 19相关的CLOCCs的神经学特征，并深入了解其潜在的病理生理学机制。
对入住我们神经疾病科的与COVID - 19相关的CLOCCs患者进行回顾性评估。评估包括对临床表现、实验室检查结果和放射学数据的综合分析。
从2022年12月17日至2023年12月31日，我们中心在8例临床确诊为COVID - 19且接受了脑磁共振成像（MRI）检查的个体中发现了CLOCCs。大多数患者（7/8）在出现神经症状之前有发热症状。神经学表现的范围包括意识改变（5/8）、头痛（4/8）、认知和行为障碍（4/8）、共济失调（2/8）、构音障碍（2/8）、锥体束征（2/8）和视力障碍（2/8）。外周血炎症和细胞溶解标志物显示出与疾病进展平行的趋势。仅1例患者脑脊液蛋白水平升高，而细胞计数、葡萄糖和氯化物水平无明显异常。使用糖皮质激素和抗病毒药物治疗后临床完全缓解，随后的MRI检查（7/8）显示治疗后3天至2周内放射学有改善。
我们的研究表明，与COVID - 19相关的CLOCCs具有预后良好和独特的MRI特征，这与在其他临床情况下观察到的情况相似。这强调了在COVID - 19的鉴别诊断中纳入CLOCCs的重要性，并突出了持续研究以解决SARS-CoV-2感染的神经状况并为预防和治疗策略提供依据的必要性。
