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COVID-19-related intracranial imaging findings: a large single-centre experience

V Sawlani1, S Scotton2, K Nader1

  • 1Department of Neuroradiology, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK; University of Birmingham, Birmingham, UK.

Clinical Radiology
|October 7, 2020
PubMed

Insights

COVID-19 patients frequently show neurological symptoms. Microhemorrhages in the corpus callosum were the most common neuroradiological finding in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.

Area of Science:

  • Neuroradiology
  • Neurology
  • Infectious Diseases

Background:

  • Coronavirus disease 2019 (COVID-19) is caused by SARS-CoV-2.
  • Neurological manifestations are observed in some COVID-19 patients.
  • Neuroimaging is crucial for evaluating these neurological complications.

Purpose of the Study:

  • To describe the neuroradiological changes in patients with COVID-19.
  • To identify common neuroimaging patterns associated with SARS-CoV-2 infection.
  • To correlate imaging findings with clinical presentation and disease severity.

Main Methods:

  • Retrospective review of 3,403 COVID-19 patients admitted between March and May 2020.
  • Analysis of neuroimaging (MRI and CT) in 167 patients with neurological signs/symptoms.
  • Detailed evaluation of abnormal brain imaging findings.

Main Results:

  • 4.9% of COVID-19 patients (167/3,403) had neurological symptoms.
  • Common indications for neuroimaging included delirium, focal neurology, and altered consciousness.
  • 23% of neuroimaging studies showed abnormalities, with microhemorrhages being the most frequent finding (60% of abnormal MRIs).
  • Other findings included infarcts, white matter hyperintensities, and acute haemorrhagic necrotising encephalopathy.

Conclusions:

  • Microhemorrhages, particularly in the splenium of the corpus callosum, are a common neuroradiological finding in COVID-19.
  • Other observed patterns include stroke, white matter changes, and encephalopathy.
  • Pathological drivers likely involve hypoxemia, coagulopathy, and endothelial dysfunction, reflecting disease severity.
Abstract

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