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COVID-19 associated intracranial vasculopathy-MRI vessel wall imaging as adjunct to emergent CT angiography-a case

David Raban1, Krystle Barhaghi1, Vincent Timpone1

  • 1Neuroradiology Section, Department of Radiology, University of Colorado Anschutz Medical Campus, Leprino Building, 12401 East 17th Avenue, Aurora, CO, 80045, USA.

Emergency Radiology
|May 26, 2021
PubMed

Insights

This case study shows COVID-19 can cause severe neurological issues like ischemic stroke due to vascular inflammation. Intracranial vessel wall imaging is crucial for diagnosing these extrapulmonary manifestations.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Vascular Medicine

Background:

  • COVID-19 initially recognized for pulmonary symptoms.
  • Emerging evidence points to extrapulmonary manifestations, particularly vascular endothelium involvement.
  • Viral tropism can lead to systemic complications beyond the respiratory system.

Observation:

  • An adult patient presented with neurological deficits disproportionate to mild pulmonary symptoms.
  • Diagnostic workup revealed a subacute ischemic stroke.
  • CT angiography indicated active inflammatory vasculopathy.

Findings:

  • The patient's stroke was linked to COVID-19-induced inflammatory vasculopathy.
  • Vascular wall imaging proved essential in identifying the underlying cause of the stroke.
  • This case underscores the neurological impact of SARS-CoV-2 infection.

Implications:

  • Emergency department protocols for stroke patients with recent COVID-19 should include intracranial vessel wall imaging.
  • Assessing for inflammatory vasculopathy is critical in these cases.
  • This approach may improve diagnosis and management of COVID-19-related neurological complications.

Keywords:
COVID-19CT angiographyMRI vessel wall imagingStroke

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