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
. 2022 Sep:134:18-24.
doi: 10.1016/j.pediatrneurol.2022.06.007. Epub 2022 Jun 16.

Cerebrovascular Complications of COVID-19 Disease in Children: A Single-Center Case Series

Klára Španělová  1 , Tamara Skříšovská  2 , Patrícia Mužlayová  1 , Ondřej Horák  1 , Jan Šenkyřík  3 , Anna Seehofnerová  3 , Lukáš Homola  4 , Jozef Klučka  2 , Jan Blatný  5 , Hana Ošlejšková  1 , Pavlína Danhofer  6
Affiliations

Cerebrovascular Complications of COVID-19 Disease in Children: A Single-Center Case Series

Klára Španělová et al. Pediatr Neurol. 2022 Sep.

Abstract

This work presents a case series of four children diagnosed with severe cerebrovascular disease in association with recent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, yet no patient from the group met typical diagnostic criteria for multisystem inflammatory syndrome in children. Our aim was to highlight the possible vascular involvement and coagulopathies associated with SARS-CoV-2 infection in the pediatric population. Further data are needed to better understand the pathophysiological basis of this condition in children and to ensure its optimal management.

Keywords: Brain vasculopathy; COVID-19; Children; SARS-CoV-2; Stroke.

PubMed Disclaimer

Figures

FIGURE 1
FIGURE 1
(A) Noncontrast brain CT, at onset (axial plane): Left-sided subdural hematoma. (B) Brain MRI, day 6 after surgery, T2 tse (axial plane): Bilateral subdural hematoma. (C) Brain MRI, 1-month follow-up, T1 mprage precontrast and postcontrast (axial plane): Left temporal arachnoideal cyst with older hemorrhagic component, bilateral residual subdural hematoma and pachymeningeal contrast enhancement more pronounced on the left side. CT, computed tomography; MRI, magnetic resonance imaging.
FIGURE 2
FIGURE 2
(A) Brain MRI, at onset, DWI and ADC maps (axial plane): Area of cytotoxic edema of left mesencephalon. (B) Brain MRI, at onset, GRE (axial plane) and T1 mprage (sagittal plane): Discrete subarachnoideal hemorrhage in the prepontine cistern. (C) Brain MRI, at onset, T1 tse blood suppression postcontrast and subtracted (axial plane): Left P1 of ACP wall enhancement. ACP, arteria cerebri posterior; ADC, apparent diffusion coefficient; DWI, diffusion weighted imaging; GRE, multiecho gradient recalled echo; MRI, magnetic resonance imaging.
FIGURE 3
FIGURE 3
Brain MRI, 1 week after onset, T2 tse (axial plane): Lacunar lesion in the left basal nuclei. MRI, magnetic resonance imaging.
FIGURE 4
FIGURE 4
(A) Brain CT, at onset (coronary and axial plane): Large hypodense ischemic area of left temporal, occipital and parietal lobe with profound hemorrhagic component and moderate midline shift. (B) Brain MRI, day 1 follow-up, T1 tse and T2 tse (axial plane): Extensive hemorrhagic venous infarction of left temporal, occipital and parietal lobe. (C) Brain MRI, day 1 follow-up, TOF 3D venography (3D rec): Left-sided cerebral venous sinus thrombosis propagating into the left internal jugular vein. CT, computed tomography; MRI, magnetic resonance imaging; TOF, time-of-flight.
See this image and copyright information in PMC

Comment in

References

    1. Hanafi R., Roger P.A., Kuchcinski G., et al. COVID-19 neurologic complications with CNS vasculitis-like pattern. AJNR Am J Neuroradiol. 2020;41:1384–1387. - PMC - PubMed
    1. Kirschenbaum D., Imbach L.L., Rushing E.J., et al. Intracerebral endotheliitis and microbleeds are neuropathological features of COVID-19. Neuropathol Appl Neurobiol. 2021;47:454–459. - PMC - PubMed
    1. Vaschetto R., Cena T., Sainaghi P.P., et al. Cerebral nervous system vasculitis in a Covid-19 patient with pneumonia. J Clin Neurosci. 2020;79:71–73. - PMC - PubMed
    1. Stevens S.M., Woller S.C., Kreuziger L.B., et al. Antithrombotic therapy for VTE disease: second update of the CHEST guideline and expert panel report. Chest. 2021;160:e545–e608. - PubMed
    1. Gutierrez Amezcua J.M., Jain R., Kleinman G., et al. COVID-19-induced neurovascular injury: a case series with emphasis on pathophysiological mechanisms. SN Compr Clin Med. 2020;2:2109–2125. - PMC - PubMed

Supplementary concepts