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Radiologic-Pathologic Correlation of COVID-19-Associated Acute Disseminated Encephalomyelitis

Amy Bezold1, Huda Hussain2, Julum Nwanze3

  • 1Vascular and Interventional Radiology, University of Texas Medical Branch, Galveston, USA.

Cureus
|August 22, 2023
PubMed

Insights

This study reports the first radiologic-pathologic correlation of acute disseminated encephalomyelitis (ADEM) in a COVID-19 patient. The findings link SARS-CoV-2 infection to inflammatory brain lesions, offering new insights into neurological complications.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Radiology

Background:

  • COVID-19 is increasingly associated with diverse neurological manifestations.
  • Acute disseminated encephalomyelitis (ADEM) is a rare immune-mediated inflammatory demyelinating disease.
  • The link between COVID-19 and ADEM requires further investigation and radiologic-pathologic correlation.

Observation:

  • A 42-year-old woman with a recent positive COVID-19 test presented with acute neurological deficits including inability to walk and talk.
  • Brain MRI revealed multifocal white matter lesions with enhancement, suggestive of inflammatory demyelination.
  • Previous evaluations were inconclusive, highlighting the need for advanced diagnostic approaches.

Findings:

  • The patient was diagnosed with inflammatory demyelinating lesions via brain biopsy.
  • These histopathological findings confirmed ADEM.
  • The case establishes a direct radiologic-pathologic correlation between COVID-19 and ADEM.

Implications:

  • This case highlights COVID-19 as a potential trigger for ADEM.
  • Understanding this association is crucial for diagnosing and managing neurological complications of COVID-19.
  • Further research is warranted to elucidate the pathogenesis and long-term outcomes of COVID-19-associated ADEM.
Keywords:
acute disseminated encephalomyelitis (adem)atypical covidcovid 19mri flair sequencesrare cause of altered mental status

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