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Neuroimaging Patterns in Patients with COVID-19-Associated Neurological Complications: A Review.
Garg, Ravindra K; Paliwal, Vimal K; Malhotra, Hardeep S; Sharma, Praveen K.
  • Garg RK; Department of Neurology, King George Medical University, Lucknow, Uttar Pradesh, India.
  • Paliwal VK; Department of Neurology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Rae Bareli Road, Lucknow, Uttar Pradesh, India.
  • Malhotra HS; Department of Neurology, King George Medical University, Lucknow, Uttar Pradesh, India.
  • Sharma PK; Department of Neurology, King George Medical University, Lucknow, Uttar Pradesh, India.
Neurol India ; 69(2): 260-271, 2021.
Article in English | MEDLINE | ID: covidwho-1290494
Semantic information from SemMedBD (by NLM)
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3. White matter lesions COEXISTS_WITH Encephalomyeliti
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7. Hemorrhage PROCESS_OF Patients
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Hemorrhage
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8. Infarction PROCESS_OF Patients
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9. neurological complication PROCESS_OF Patients
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neurological complication
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11. White matter lesions COEXISTS_WITH Encephalomyelitis, Acute Disseminated
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Encephalomyelitis, Acute Disseminated
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COVID-19
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ABSTRACT

BACKGROUND:

A variety of neuroimaging abnormalities in COVID-19 have been described.

OBJECTIVES:

In this article, we reviewed the varied neuroimaging patterns in patients with COVID-19-associated neurological complications.

METHODS:

We searched PubMed, Google Scholar, Scopus and preprint databases (medRxiv and bioRxiv). The search terms we used were "COVID -19 and encephalitis, encephalopathy, neuroimaging or neuroradiology" and "SARS-CoV-2 and encephalitis, encephalopathy, neuroimaging or neuroradiology".

RESULTS:

Neuroimaging abnormalities are common in old age and patients with comorbidities. Neuroimaging abnormalities are largely vascular in origin. COVID-19-associated coagulopathy results in large vessel occlusion and cerebral venous thrombosis. COVID-19-associated intracerebral hemorrhage resembles anticoagulant associated intracerebral hemorrhage. On neuroimaging, hypoxic-ischemic damage along with hyperimmune reaction against the SARS-COV-2 virus manifests as small vessel disease. Small vessel disease appears as diffuse leukoencephalopathy and widespread microbleeds, and subcortical white matter hyperintensities. Occasionally, gray matter hyperintensity, similar to those observed seen in autoimmune encephalitis, has been noted. In many cases, white matter lesions similar to that in acute disseminated encephalomyelitis have been described. Acute disseminated encephalomyelitis in COVID-19 seems to be a parainfectious event and autoimmune in origin. Many cases of acute necrotizing encephalitis resulting in extensive damage to thalamus and brain stem have been described; cytokine storm has been considered a pathogenic mechanism behind this. None of the neuroimaging abnormalities can provide a clue to the possible pathogenic mechanism.

CONCLUSIONS:

Periventricular white-matter MR hyperintensity, microbleeds, arterial and venous infarcts, and hemorrhages are apparently distinctive neuroimaging abnormalities in patients with COVID-19.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Neuroimaging / SARS-CoV-2 / COVID-19 / Nervous System Diseases Type of study: Reviews / Risk factors Topics: Long Covid Limits: Humans Language: English Journal: Neurol India Year: 2021 Document Type: Article Affiliation country: 0028-3886.314531

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Neuroimaging / SARS-CoV-2 / COVID-19 / Nervous System Diseases Type of study: Reviews / Risk factors Topics: Long Covid Limits: Humans Language: English Journal: Neurol India Year: 2021 Document Type: Article Affiliation country: 0028-3886.314531