COVID-19-Associated PRES-like Encephalopathy with Perivascular Gadolinium Enhancement

Area of Science:

• Neurology
• Infectious Diseases
• Radiology

Background:

• Coronavirus disease 2019 (COVID-19) is a global pandemic with diverse clinical manifestations.
• Neurological complications of COVID-19 are increasingly recognized, impacting various brain structures.
• Acute encephalopathy represents a severe neurological dysfunction that can occur during viral infections.

Observation:

• A 63-year-old female patient presented with symptoms indicative of acute encephalopathy.
• The patient had a confirmed diagnosis of coronavirus disease 2019 (COVID-19).
• Cerebral magnetic resonance imaging (MRI) revealed characteristic perivascular gadolinium enhancement.

Findings:

• The observed perivascular gadolinium enhancement suggests inflammation along the cerebral vasculature.
• This pattern of enhancement is a key radiological finding in COVID-19-associated acute encephalopathy.
• The case highlights a specific neuroimaging biomarker for this severe neurological complication.

Implications:

• Understanding the neuroimaging findings in COVID-19-associated encephalopathy is crucial for diagnosis and management.
• Perivascular enhancement may indicate a specific pathophysiological mechanism, potentially involving blood-brain barrier disruption.
• This case contributes to the growing body of evidence on the neurological sequelae of COVID-19, informing future research and clinical practice.