Spectrum of common and uncommon neurovascular and neurological manifestations of COVID-19 on cross-sectional imaging

ABSTRACT

COVID-19 is an emerging and re-emerging disease that is caused by SARS CoV-2, a neurotropic virus that frequently involves the central nervous system in ad-dition to the lungs. Findings on neuroimaging can be observed in a significant percentage of active COVID-19 and post-COVID patients, especially those who are/ have been critically ill. Accurate diagnosis of such cases on imaging aids in appropriate patient management and prevention of permanent neurological deficits. The features of CNS involvement in COVID-19 can be broadly categorized as the more common neurovas-cular and relatively uncommon neurological manifes-tations. Several pathophysiological mechanisms have been proposed for the patterns of CNS involvement and corresponding neuroimaging features in COVID-19. We have outlined the pathophysiology and indications for neuroimaging in COVID-19 and extensively discussed the neuroimaging features of the entire spectrum of neurovascular and neurological manifestations, in-cluding the rare and diagnostically challenging ones, through case-based illustrations. As new strains of COVID-19 continue to emerge, radiologists need to be aware of the imaging features of various neurological and neurovascular manifestations of CNS involvement in COVID-19 as timely diagnosis is vital in preventing or limiting permanent neurological deficits in such cases. © 2022, Zita Medical Managent. All rights reserved.