Search

Neuropsychological deficits and brain damage following SARS‐CoV‐2 infection are not well understood. Then, 116 patients, with either severe, moderate, or mild disease in the acute phase underwent neuropsychological and olfactory tests, as well as completed psychiatric and respiratory questionnaires at 223 ± 42 days postinfection. Additionally, a subgroup of 50 patients underwent functional magnetic resonance imaging. Patients in the severe group displayed poorer verbal episodic memory performances, and moderate patients had reduced mental flexibility. Neuroimaging revealed patterns of hypofunctional and hyperfunctional connectivities in severe patients, while only hyperconnectivity patterns were observed for moderate. The default mode, somatosensory, dorsal attention, subcortical, and cerebellar networks were implicated. Partial least squares correlations analysis confirmed specific association between memory, executive functions performances and brain functional connectivity. The severity of the infection in the acute phase is a predictor of neuropsychological performance 6–9 months following SARS‐CoV‐2 infection. SARS‐CoV‐2 infection causes long‐term memory and executive dysfunctions, related to large‐scale functional brain connectivity alterations. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "Basal Ganglia Infarction Complicating Basilar Meningitis: Visualization by Serial Magnetic Resonance Imaging," by Gian P. Ramelli, Chritoph Aebi, Luca Remonda and Karl O. Lövblad in the 2005 issue.

Purpose: We aimed to evaluate whether virtual non-contrast cerebral computed tomography (VNCCT) reconstructed from intravenous contrast-enhanced dual-energy CT (iv-DECT) could replace non-contrast CT (NCCT) in patients with suspected acute cerebral ischemia. Method: This retrospective study included all consecutive patients in whom NCCT followed by iv-DECT were performed for suspected acute ischemia in our emergency department over a 1-month period. The Alberta Stroke Program Early CT Score (ASPECTS) was used to determine signs of acute ischemia in the anterior and posterior circulation, the presence of hemorrhage, and alternative findings, which were randomly evaluated via the consensus reading of NCCT and VNCCT by two readers blinded to the final diagnosis. An intraclass correlation between VNCCT and NCCT was calculated for the ASPECTS values. Both techniques were evaluated for their ability to detect ischemic lesions (ASPECTS <10) when compared with the final discharge diagnosis (reference standard). Results: Overall, 148 patients (80 men, mean age 64 years) were included, of whom 46 (30%) presented with acute ischemia, 6 (4%) presented with intracerebral hemorrhage, 11 (7%) had an alternative diagnosis, and 85 (59%) had no pathological findings. The intraclass correlation coefficients of the two modalities were 0.97 (0.96-0.98) for the anterior circulation and 0.77 (0.69-0.83) for the posterior circulation. The VNCCT's sensitivity for detecting acute ischemia was higher (41%, 19/46) than that of NCCT (33%, 15/46). Specificity was similar between the two techniques, at 94% (97/103) and 98% (101/103), respectively. Conclusions: Our results show that VNCCT achieved a similar diagnostic performance as NCCT and could, thus, replace NCCT in assessing patients with suspected acute cerebral ischemia.

Intracranial aneurysms (IAs) are usually asymptomatic with a low risk of rupture, but consequences of aneurysmal subarachnoid hemorrhage (aSAH) are severe. Identifying IAs at risk of rupture has important clinical and socio-economic consequences. The goal of this study was to assess the effect of patient and IA characteristics on the likelihood of IA being diagnosed incidentally versus ruptured. Patients were recruited at 21 international centers. Seven phenotypic patient characteristics and three IA characteristics were recorded. The analyzed cohort included 7992 patients. Multivariate analysis demonstrated that: (1) IA location is the strongest factor associated with IA rupture status at diagnosis; (2) Risk factor awareness (hypertension, smoking) increases the likelihood of being diagnosed with unruptured IA; (3) Patients with ruptured IAs in high-risk locations tend to be older, and their IAs are smaller; (4) Smokers with ruptured IAs tend to be younger, and their IAs are larger; (5) Female patients with ruptured IAs tend to be older, and their IAs are smaller; (6) IA size and age at rupture correlate. The assessment of associations regarding patient and IA characteristics with IA rupture allows us to refine IA disease models and provide data to develop risk instruments for clinicians to support personalized decision-making., Competing Interests: The authors declare no conflict of interest.