1. Neurological complications in COVID-19 – a diagnostic challenge
- Author
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Sorina Frunze, Vitalie Vacaras, and Adrian Mihai Cordos
- Subjects
Male ,Neurology ,BMI – body mass index ,Computed Tomography Angiography ,030204 cardiovascular system & hematology ,MRI – Magnetic resonance imaging ,Antibodies, Viral ,HR – heart rate ,PCR – polymerase chain reaction ,0302 clinical medicine ,SAH – subarachnoid hemorrhage ,BBB – blood-brain barrier ,I.V. – intravenous ,Stroke ,LMWH – low molecular weight heparin ,CRP – C-reactive protein ,medicine.diagnostic_test ,ECG – electrocardiogram ,UL – upper limit ,BP – blood pressure ,General Medicine ,Middle Aged ,Thorax ,CSF – cerebrospinal fluid ,Magnetic Resonance Imaging ,stroke ,COVID-19 – coronavirus disease ,CT – Computer tomography ,MRA – Magnetic resonance angiography ,SARS-CoV-2 – severe acute respiratory syndrome coronavirus 2 ,ACE2 – angiotensin converting enzyme II ,CVT – cerebral venous thrombosis ,cardiovascular medicine ,Original Article ,Headaches ,medicine.symptom ,MRC scale – Medical Research Council's scale ,CNS – central nervous system ,medicine.medical_specialty ,Subarachnoid hemorrhage ,Coronavirus disease 2019 (COVID-19) ,subarachnoid hemorrhage ,PCoA – posterior communicating artery ,RCVS – reversible cerebral vasoconstriction syndrome ,RR – reference range ,03 medical and health sciences ,medicine ,Humans ,RT-PCR – real-time polymerase chain reaction ,Intensive care medicine ,Holter ECG – Holter electrocardiogram ,Pandemics ,PCA – posterior cerebral artery ,business.industry ,SARS-CoV-2 ,neurology ,COVID-19 ,Magnetic resonance imaging ,medicine.disease ,CTA – Computer tomography angiography ,Concomitant ,PACNS – primary angiitis of the central nervous system ,Nervous System Diseases ,business ,Motor Deficit ,Tomography, X-Ray Computed ,030217 neurology & neurosurgery - Abstract
With the exponential growth of COVID-19 cases, the neurological complications reported during or after the infection became more common. There is limited knowledge regarding the pathophysiological mechanisms that are responsible for these complications. Recent data provides compelling evidence for the neurotropic nature of SARS-CoV-2, based on neurological manifestations reported during the current pandemic, as well as on previous experience with other coronaviruses. We present the case of a patient who developed headaches, motor deficit and dysphasia after respiratory COVID-19. Imaging tests showed heterogeneous central nervous system lesions (multiple subarachnoid hemorrhages and two ischemic strokes). Given the plethora of atypical neurological complications of COVID-19 described in the current literature, establishing a positive diagnosis and deciding on a treatment plan proved to be particularly challenging. We set to discuss some of the possible pathologies, hypothesized to be associated with COVID-19, that could lead to concomitant neurological lesions, similar to those noticed in our patient.
- Published
- 2021