Brain MRI Findings in Patients in the Intensive Care Unit with COVID-19 Infection

Sedat G Kandemirli, Lerzan Dogan, Zeynep T Sarikaya, Simay Kara, Canan Akinci, Dilaver Kaya, Yildiz Kaya, Duzgun Yildirim, Filiz Tuzuner, Mustafa S Yildirim, Enes Ozluk, Bulent Gucyetmez, Ercan Karaarslan, Isil Koyluoglu, Hande S Demirel Kaya, Orkhan Mammadov, Ilkay Kisa Ozdemir, Nazire Afsar, Beyza Citci Yalcinkaya, Sevdinaz Rasimoglu, Duygu E Guduk, Ararso Kedir Jima, Aylin Ilksoz, Vildan Ersoz, Meltem Yonca Eren, Nilufer Celtik, Serdar Arslan, Bora Korkmazer, Saban S Dincer, Elif Gulek, Ibrahim Dikmen, Murathan Yazici, Serkan Unsal, Taner Ljama, Ismail Demirel, Aykut Ayyildiz, Isil Kesimci, Sahika Bolsoy Deveci, Melih Tutuncu, Osman Kizilkilic, Lutfi Telci, Rehile Zengin, Alp Dincer, Ibrahim O Akinci, Naci Kocer, Sedat G Kandemirli, Lerzan Dogan, Zeynep T Sarikaya, Simay Kara, Canan Akinci, Dilaver Kaya, Yildiz Kaya, Duzgun Yildirim, Filiz Tuzuner, Mustafa S Yildirim, Enes Ozluk, Bulent Gucyetmez, Ercan Karaarslan, Isil Koyluoglu, Hande S Demirel Kaya, Orkhan Mammadov, Ilkay Kisa Ozdemir, Nazire Afsar, Beyza Citci Yalcinkaya, Sevdinaz Rasimoglu, Duygu E Guduk, Ararso Kedir Jima, Aylin Ilksoz, Vildan Ersoz, Meltem Yonca Eren, Nilufer Celtik, Serdar Arslan, Bora Korkmazer, Saban S Dincer, Elif Gulek, Ibrahim Dikmen, Murathan Yazici, Serkan Unsal, Taner Ljama, Ismail Demirel, Aykut Ayyildiz, Isil Kesimci, Sahika Bolsoy Deveci, Melih Tutuncu, Osman Kizilkilic, Lutfi Telci, Rehile Zengin, Alp Dincer, Ibrahim O Akinci, Naci Kocer

Abstract

Online supplemental material is available for this article.

Figures

Figure 1:
Figure 1:
Flowchart of patient inclusion. COVID-19 = coronavirus disease 2019, RT-PCR = reverse-transcription polymerase chain reaction.
Figure 2:
Figure 2:
Contrast material–enhanced cranial 1.5-T MRI scans in a 59-year-old intubated man with altered mental status despite tapering of sedoanalgesia. A, B, Axial fluid-attenuated inversion recovery images at level of, A, midbrain and, B, centrum semiovale demonstrate prominent symmetric white matter hyperintensity and right frontal cortical hyperintensity. Prominent linear hyperintensity within frontal sulci is also shown. C, Axial diffusion-weighted image (b = 2000 sec/mm2) shows frontal increased signal intensity. There was also a corresponding low apparent diffusion coefficient (not shown) D, Axial T1-weighted image shows right frontal sulcal effacement. E, Postcontrast T1-weighted image shows mild pial-subarachnoid enhancement. F, G, Axial susceptibility-weighted images at level of, F, corona radiata and, G, centrum semiovale demonstrate blooming artifact in the frontal sulci. H, Postcontrast fluid-attenuated inversion recovery image depicts bilateral leptomeningeal enhancement.

References

    1. Mao L, Jin H, Wang M, et al. Neurologic Manifestations of Hospitalized Patients With Coronavirus Disease 2019 in Wuhan, China. JAMA Neurol 2020 Apr 10 [Epub ahead of print].
    1. Desforges M, Le Coupanec A, Stodola JK, Meessen-Pinard M, Talbot PJ. Human coronaviruses: viral and cellular factors involved in neuroinvasiveness and neuropathogenesis. Virus Res 2014;194:145–158.
    1. Moriguchi T, Harii N, Goto J, et al. A first case of meningitis/encephalitis associated with SARS-Coronavirus-2. Int J Infect Dis 2020;94:55–58.
    1. Poyiadji N, Shahin G, Noujaim D, Stone M, Patel S, Griffith B. COVID-19-associated Acute Hemorrhagic Necrotizing Encephalopathy: CT and MRI Features. Radiology 2020 Mar 31:201187 [Epub ahead of print].
    1. Helms J, Kremer S, Merdji H, et al. Neurologic Features in Severe SARS-CoV-2 Infection. N Engl J Med 2020 Apr 15 [Epub ahead of print] 10.1056/NEJMc2008597.
    1. Morfopoulou S, Brown JR, Davies EG, et al. Human Coronavirus OC43 Associated with Fatal Encephalitis. N Engl J Med 2016;375(5):497–498.
    1. Tsai LK, Hsieh ST, Chang YC. Neurological manifestations in severe acute respiratory syndrome. Acta Neurol Taiwan 2005;14(3):113–119.
    1. Mehta P, McAuley DF, Brown M, et al. COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet 2020;395(10229):1033–1034.
    1. Umapathi T, Kor AC, Venketasubramanian N, et al. Large artery ischaemic stroke in severe acute respiratory syndrome (SARS). J Neurol 2004;251(10):1227–1231.
    1. Koeller KK, Shih RY. Viral and Prion Infections of the Central Nervous System: Radiologic-Pathologic Correlation: From the Radiologic Pathology Archives. RadioGraphics 2017;37(1):199–233.
    1. Kelley BP, Patel SC, Marin HL, Corrigan JJ, Mitsias PD, Griffith B. Autoimmune Encephalitis: Pathophysiology and Imaging Review of an Overlooked Diagnosis. AJNR Am J Neuroradiol 2017;38(6):1070–1078.
    1. Cianfoni A, Caulo M, Cerase A, et al. Seizure-induced brain lesions: a wide spectrum of variably reversible MRI abnormalities. Eur J Radiol 2013;82(11):1964–1972.
    1. Muttikkal TJ, Wintermark M. MRI patterns of global hypoxic-ischemic injury in adults. J Neuroradiol 2013;40(3):164–171.
    1. Bathla G, Policeni B, Agarwal A. Neuroimaging in patients with abnormal blood glucose levels. AJNR Am J Neuroradiol 2014;35(5):833–840.
    1. McKinney AM, Sarikaya B, Gustafson C, Truwit CL. Detection of microhemorrhage in posterior reversible encephalopathy syndrome using susceptibility-weighted imaging. AJNR Am J Neuroradiol 2012;33(5):896–903.
    1. Fanou EM, Coutinho JM, Shannon P, et al. Critical Illness-Associated Cerebral Microbleeds. Stroke 2017;48(4):1085–1087.

Source: PubMed

3
Iratkozz fel