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Updated: Nov 11, 2025

Longitudinal In Vivo Imaging of the Cerebrovasculature: Relevance to CNS Diseases
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Cerebrovascular Complications and Vessel Wall Imaging in COVID-19 Encephalopathy-A Pilot Study

Marjolaine Uginet1, Gautier Breville1, Jérémy Hofmeister2

  • 1Division of Neurology, Clinical Neurosciences Department, Geneva University Hospitals, Geneva, Switzerland.

Clinical Neuroradiology
|March 26, 2021
PubMed

Insights

COVID-19 can cause acute encephalopathy. High-resolution MRI revealed vascular changes, specifically circular enhancement and thickening of basilar and vertebral arteries, suggesting endotheliitis as a potential inflammatory mechanism.

Area of Science:

  • Neurology
  • Radiology
  • Infectious Diseases

Background:

  • COVID-19, caused by SARS-CoV-2, is linked to central nervous system (CNS) complications.
  • Acute encephalopathy is a recognized neurological complication of COVID-19.

Purpose of the Study:

  • To investigate vascular changes in the brain of patients with COVID-19-associated acute encephalopathy.
  • To explore potential inflammatory mechanisms underlying COVID-19 encephalopathy.

Main Methods:

  • Pilot study involving 39 patients with acute encephalopathy during the symptomatic phase of COVID-19.
  • Standard 1.5T brain MRI including diffusion-weighted imaging, MR angiography, susceptibility-weighted images, and high-resolution vascular black blood sequences (in 34 cases).

Main Results:

  • In 85% of patients with high-resolution vessel wall imaging (29/34), circular enhancement and thickening of basilar and vertebral arteries were observed.
  • These vascular changes showed no correlation with the presence of ischemia or microbleeds.

Conclusions:

  • A high prevalence of vascular changes, suggestive of endotheliitis, was found in COVID-19 encephalopathy patients.
  • These findings support an inflammatory mechanism, potentially endotheliitis, as a cause of COVID-19-associated acute encephalopathy.
Abstract

Keywords:
Contrast agentDiffusionInflammationMRISWIStroke

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