Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2020 Sep 15:416:117035.
doi: 10.1016/j.jns.2020.117035. Epub 2020 Jul 15.

A Rare Case of Acute Hemorrhagic Leukoencephalitis in a COVID-19 Patient

Ming Hui Yong  1 , Yvonne Fu Zi Chan  2 , Jiaxuan Liu  3 , Sarat Kumar Sanamandra  4 , Si Wei Kheok  4 , Kheng Choon Lim  4 , Duu Wen Sewa  3
Affiliations
Case Reports

A Rare Case of Acute Hemorrhagic Leukoencephalitis in a COVID-19 Patient

Ming Hui Yong et al. J Neurol Sci. .
No abstract available

Keywords: Acute disseminated encephalomyelitis; Acute hemorrhagic encephalomyelitis; Acute hemorrhagic leukoencephalitis; COVID-19; MRI.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
MRI brain images of our COVID-19 patient with AHLE. MRI Brain axial T2-weighted images at the level of cerebellar hemispheres (A), thalami (B) and frontoparietal lobes (C) demonstrate multifocal asymmetric areas of heterogeneous hyperintensity, predominantly involving the subcortical white matter and thalami (arrowheads). Susceptibility weighted images (SWI) at the corresponding levels (D, E, F) show innumerable foci of punctate hemorrhages scattered throughout the brain parenchyma with several clusters present within aforementioned lesions, including the left thalamus (arrowheads). Post contrast axial T1-weighted images (G, H, I) display subtle patchy enhancement of the majority of the lesions (arrowheads) in addition to incomplete ring enhancement of the left thalamic lesion (arrow in image “H”). DWI (J, K, L) and ADC (M, N, O) images show only limited areas of restricted diffusion within the lesions (arrowheads). There is associated mass effect, best appreciated around the dominant lesion in the left temporo-parieto-occipital lobe.
Fig. 2
Fig. 2
Maximum intensity projections of 3D TOF-MRA of the circle of Willis in (A) craniocaudal (B) anteroposterior (C) lateral projections show smooth flow signal with no significant proximal vessel stenosis or occlusion. There is displacement and paucity of vessels over the dominant left temporo-parieto-occipital lesion, likely due to mass effect.
See this image and copyright information in PMC

References

    1. Mao L., Jin H., Wang M. Neurologic Manifestations of Hospitalized Patients With Coronavirus Disease 2019 in Wuhan, China. JAMA Neurol Epub. 2020 doi: 10.1001/jamaneurol.2020.1127. e201127. - DOI - PMC - PubMed
    1. Helms J., Kremer S., Merdji H. Neurologic Features in Severe SARS-CoV-2 Infection. N Engl J Med Epub. 2020 doi: 10.1056/NEJMc2008597. - DOI - PMC - PubMed
    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 Epub. 2020;201187 doi: 10.1148/radiol.2020201187. - DOI - PMC - PubMed
    1. Rossi A. Imaging of acute disseminated encephalomyelitis. Neuroimaging Clin. N. Am. 2008;18:149–ix. doi: 10.1016/j.nic.2007.12.007. - DOI - PubMed
    1. Baig A.M., Khaleeq A., Ali U., Syeda H. Evidence of the COVID-19 virus targeting the CNS: tissue distribution, host-virus interaction, and proposed neurotropic mechanisms. ACS Chem. Neurosci. 2020;11(7):995–998. doi: 10.1021/acschemneuro.0c00122. - DOI - PubMed

MeSH terms