Neurological emergencies associated with COVID-19: stroke and beyond

Emerg Radiol. 2020 Dec;27(6):747-754. doi: 10.1007/s10140-020-01837-7. Epub 2020 Aug 11.

Abstract

Novel coronavirus disease (COVID-19) was declared a global pandemic on March 1, 2020. Neurological manifestations are now being reported worldwide, including emergent presentation with acute neurological changes as well as a comorbidity in hospitalized patients. There is limited knowledge on the neurologic manifestations of COVID-19 at present, with a wide array of neurological complications reported, ranging from ischemic stroke to acute demyelination and encephalitis. We report five cases of COVID-19 presenting to the ER with acute neurological symptoms, over the course of 1 month. This includes two cases of ischemic stroke, one with large-vessel occlusion and one with embolic infarcts. The remainders of the cases include acute tumefactive demyelination, isolated cytotoxic edema of the corpus callosum with subarachnoid hemorrhage, and posterior reversible encephalopathy syndrome (PRES).

Keywords: COVID-19; Hypercoagulable; MRI; Neurological; Neurotropism.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • Betacoronavirus
  • Brain Diseases / diagnostic imaging*
  • Brain Diseases / therapy
  • Brain Diseases / virology*
  • COVID-19
  • Cerebral Angiography
  • Computed Tomography Angiography
  • Coronavirus Infections / complications*
  • Coronavirus Infections / therapy
  • Emergencies*
  • Fatal Outcome
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Neuroimaging / methods*
  • Pandemics
  • Pneumonia, Viral / complications*
  • Pneumonia, Viral / therapy
  • Posterior Leukoencephalopathy Syndrome / diagnostic imaging
  • Posterior Leukoencephalopathy Syndrome / therapy
  • Posterior Leukoencephalopathy Syndrome / virology
  • SARS-CoV-2
  • Stroke / diagnostic imaging
  • Stroke / therapy
  • Stroke / virology