Cerebral nervous system vasculitis in a Covid-19 patient with pneumonia

Abstract

We describe a patient affected by Covid-19 acute respiratory distress syndrome with a cerebral nervous system vasculitis triggered by SARS-Cov-2, managed at the University hospital, in Novara, Italy in the area most impacted by the pandemic and where 749 Covid-19 positive patients were admitted from March 1st until April 25th, 2020.

Keywords: COVID-19; Cerebral vasculitis; SARS-Cov-2.

Fig. 1

(A) The DWI map detects a signal restriction of the cortex in a parietal region characterized by weak hyperintensity (arrowhead) probably due to signs of cortical inflammation. In addition, the presence of signal restriction areas at the pons level (arrow) and in the parieto-occipital area (arrow) is observed, such as for ischemia in the subacute phase. (B) The same section is performed after administration of contrast medium and reveals leptomeningeal enhancement (arrowhead). (C) Contrast enhancement was best emphasized with late acquisition after administration of contrast medium (arrowhead).

Fig. 2

The DWI maps compare two MRI sections performed on day 21 (A) and day 36 (B). A significant reduction in signal restriction is detected on the pons, consequence of a normal evolution of the recent ischemia.