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Neurological complications in COVID-19 – a diagnostic challenge

Authors :
Sorina Frunze
Vitalie Vacaras
Adrian Mihai Cordos
Source :
Journal of Medicine and Life
Publication Year :
2021
Publisher :
Carol Davila University Press, 2021.

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.

Subjects

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

Details

Language :
English
ISSN :
18443117 and 1844122X
Volume :
14
Issue :
2
Database :
OpenAIRE
Journal :
Journal of Medicine and Life
Accession number :
edsair.doi.dedup.....748f2afbd99e4fd6173f53f6560c4fb8