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Isolated intracranial hypertension associated with COVID-19
Marcus Tulius T Silva1,2, Marco A Lima1,3, Guilherme Torezani4
1Evandro Chagas National Institute of Infectious Diseases (INI), FIOCRUZ, Brazilian Ministry of Health, Brazil.
Cephalalgia : an International Journal of Headache
|November 4, 2020
Summary
Headache in COVID-19 patients can indicate intracranial hypertension without brain inflammation. Further research is needed to understand this neurological complication and its causes.
Area of Science:
- Neurology
- Infectious Diseases
- Neuroscience
Background:
- Headache is a common symptom in COVID-19 patients, but detailed characteristics are often lacking.
- This study aimed to describe headache features and cerebrospinal fluid (CSF) profiles in COVID-19 patients, focusing on intracranial hypertension.
Observation:
- Thirteen of 56 COVID-19 patients (23.2%) presented with new, persistent headaches requiring CSF analysis.
- Headaches were typically throbbing, holocranial, or bilateral.
- CSF analysis and SARS-CoV-2 RT-qPCR were negative in all patients.
Findings:
- Elevated CSF opening pressure (>200 mmH2O) was observed in 11 patients, with six exceeding 250 mmH2O.
- A significant proportion of COVID-19 headaches were linked to intracranial hypertension without meningitic or encephalitic signs.
- Most patients experienced headache improvement, though some had persistent daily headaches.
Implications:
- COVID-19-associated headaches may be linked to intracranial hypertension, even without overt central nervous system infection.
- Potential mechanisms, such as COVID-19-related coagulopathy, require further investigation.
- Post-mortem studies of CSF production and absorption sites are recommended to elucidate the pathophysiology.
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