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COVID-19-Associated Acute Asymmetric Hemorrhagic Necrotizing Encephalopathy: A Case Report

Najo Jomaa1, Tarek El Halabi1, Jawad Melhem2

  • 1Department of Neurology, American University of Beirut Medical Center, Beirut, Lebanon.

The Neurohospitalist
|April 11, 2022
PubMed

Insights

This study reports a case of acute necrotizing encephalopathy (ANE) in a patient with Coronavirus disease 2019 (COVID-19). Neurological complications like ANE highlight the severe impact of SARS-CoV-2 on the central nervous system.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Neuroimaging

Background:

  • Coronavirus disease 2019 (COVID-19) is linked to diverse central nervous system complications.
  • Investigating rare neurological sequelae of severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) infection is crucial.

Observation:

  • A 60-year-old male with COVID-19 developed left-sided weakness post-extubation.
  • Brain MRI revealed hemorrhagic rim-enhancing lesions in the thalamus and hippocampus.
  • Neuroimaging findings were consistent with a probable variant of acute necrotizing encephalopathy (ANE).

Findings:

  • The patient's lesions demonstrated reduced cerebral blood flow and restricted diffusion.
  • These findings suggest an immune-mediated process triggered by SARS-CoV-2 infection.
  • ANE is a rare but serious neurological complication associated with COVID-19.

Implications:

  • COVID-19 can precipitate acute necrotizing encephalopathy, potentially via immune system activation.
  • Further research is needed to explore targeted therapies, such as anti-cytokine drugs, for preventing COVID-19-associated ANE.
  • This case underscores the importance of recognizing and managing neurological complications in COVID-19 patients.

Keywords:
COVID-19acute necrotizing encephalopathycase reportmagnetic resonance imaging

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