COVID-19-related intracranial imaging findings: a large single-centre experience.

Sawlani, Vijay, Scotton, S, Nader, K, Jen, J P, Patel, M, Gokani, K, Denno, P, Thaller, M, Englezou, C, Janjua, U, Bowen, M, Hoskote, C, Veenith, T, Hassan-Smith, G and Jacob, S (2020) COVID-19-related intracranial imaging findings: a large single-centre experience. Clinical radiology. ISSN 1365-229X. This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs

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Official URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC74919...

Abstract

AIM

To describe the neuroradiological changes in patients with coronavirus disease 2019 (COVID-19).

MATERIALS AND METHODS

A retrospective review was undertaken of 3,403 patients who were confirmed positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, and admitted to Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK between 1 March 2020 and 31 May 2020, and who underwent neuroimaging. Abnormal brain imaging was evaluated in detail and various imaging patterns on magnetic resonance imaging MRI were identified.

RESULTS

Of the 3,403 patients with COVID-19, 167 (4.9%) had neurological signs or symptoms warranting neuroimaging. The most common indications were delirium (44/167, 26%), focal neurology (37/167, 22%), and altered consciousness (34/167, 20%). Neuroimaging showed abnormalities in 23% of patients, with MRI being abnormal in 20 patients and computed tomography (CT) in 18 patients. The most consistent neuroradiological finding was microhaemorrhage with a predilection for the splenium of the corpus callosum (12/20, 60%) followed by acute or subacute infarct (5/20, 25%), watershed white matter hyperintensities (4/20, 20%), and susceptibility changes on susceptibility-weighted imaging (SWI) in the superficial veins (3/20, 15%), acute haemorrhagic necrotising encephalopathy (2/20, 10%), large parenchymal haemorrhage (2/20, 10%), subarachnoid haemorrhage (1/20, 5%), hypoxic-ischaemic changes (1/20, 5%), and acute disseminated encephalomyelitis (ADEM)-like changes (1/20, 5%).

CONCLUSION

Various imaging patterns on MRI were observed including acute haemorrhagic necrotising encephalopathy, white matter hyperintensities, hypoxic-ischaemic changes, ADEM-like changes, and stroke. Microhaemorrhages were the most common findings. Prolonged hypoxaemia, consumption coagulopathy, and endothelial disruption are the likely pathological drivers and reflect disease severity in this patient cohort.

Item Type: Article
Additional Information: This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs
Subjects: WC Communicabable diseases
WL Nervous system. Neurology
WN Medical imaging. Radiology
Divisions: Clinical Support > Radiology
Emergency Services > Neurology
Clinical Support > Critical Care
Related URLs:
Depositing User: Mrs Yolande Brookes
Date Deposited: 19 Nov 2020 15:39
Last Modified: 19 Nov 2020 15:39
URI: http://www.repository.uhblibrary.co.uk/id/eprint/3680

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