Radiology - Nervous System Involvement in COVID-19

Radiology - Nervous System Involvement in COVID-19: Results from a Retrospective Consecutive Neuroimaging Cohort⁠

Jul 30 2020⁠

Figure 2. Macrovascular and diffusion imaging findings.⁠

First row (A, B): Man in his late 60s with COVID-19, left side motor symptoms and left-sided ophthalmoplegia upon a routine wake up test from anesthesia. A, Non-enhanced brain CT in the axial view demonstrating an infarct of the right middle cerebral artery territory. B, Axial non-enhanced brain CT in the axial view a week later revealed hemorrhagic transformation.⁠

First row (C, D): Man in his mid-50s with COVID-19 a month after symptom onset and several weeks in the ICU. Non-enhanced brain CT in the, C, axial and, D, coronal views. Intracerebral hematoma dissecting into the ventricles and along the right tentorium. Low attenuation in the territories of right middle and posterior cerebral arteries were also found.⁠

Second row: Man in his mid-50s with COVID-19 after a month in the ICU and impaired consciousness (GCS 3) after termination of anesthesia. Brain MRI with, E, axial T2-weighted imaging, F, b1000 DWI,and, G, ADC map showing multiple, bilateral acute lacunar infarcts in the semioval centers. H, TOF MRA with normal findings.⁠

Third row: Woman in her late 40s with COVID-19, impaired consciousness and paretic extremities 2 weeks after admission to the ICU. Brain MRI with, I, axial b1000 DWI, J, ADC map, K, T2-weighted imaging, and, L, sagittal T2-weighted FLAIR showed a cytotoxic lesion of the corpus callosum in the splenium.⁠

ADC = apparent diffusion coefficient, DWI = diffusion weighted imaging, FLAIR = fluid-attenuated inversion recovery, GCS = Glasgow coma scale, ICU = intensive care unit, SWI = susceptibility-weighted imaging, TOF MRA = time-of-flight magnetic resonance angiography.