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Neuroimaging Findings in Patients with COVID-19
P Nicholson1, L Alshafai2, T Krings3
1From the Division of Neuroradiology (P.N., T.K.), Joint Department of Medical Imaging, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada patrick.nicholson@uhn.ca.
Neurologic complications of coronavirus disease 2019 (COVID-19) are poorly understood. Brain imaging in four COVID-19 patients revealed multifocal petechial hemorrhages, suggesting a thrombotic microangiopathy linked to heightened thrombosis.
Area of Science:
- Neurology
- Radiology
- Infectious Diseases
Background:
- Neurologic sequelae of coronavirus disease 2019 (COVID-19) remain largely uncharacterized.
- Understanding the neurological impact of COVID-19 is crucial for patient management.
Observation:
- Four patients positive for COVID-19 presented with abnormal mental status.
- These patients exhibited deranged coagulation parameters and elevated D-dimer levels.
Findings:
- Computed tomography (CT) and magnetic resonance (MR) imaging demonstrated multifocal subcortical/cortical petechial hemorrhages in all patients.
- Susceptibility-weighted imaging (SWI) revealed more extensive multifocal abnormalities.
- The neuroimaging findings are consistent with thrombotic microangiopathy.
Implications:
- The observed pattern suggests a potential link between COVID-19 and thrombotic microangiopathy.
- Heightened thrombosis may underlie the neurologic manifestations in some COVID-19 patients.
- Further research is warranted to elucidate the mechanisms and clinical significance of these findings.
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