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Article ; Online: Susceptibility-weighted imaging reveals cerebral microvascular injury in severe COVID-19.

Conklin, John / Frosch, Matthew P / Mukerji, Shibani S / Rapalino, Otto / Maher, Mary D / Schaefer, Pamela W / Lev, Michael H / Gonzalez, R G / Das, Sudeshna / Champion, Samantha N / Magdamo, Colin / Sen, Pritha / Harrold, G Kyle / Alabsi, Haitham / Normandin, Erica / Shaw, Bennett / Lemieux, Jacob E / Sabeti, Pardis C / Branda, John A /
Brown, Emery N / Westover, M Brandon / Huang, Susie Y / Edlow, Brian L

Journal of the neurological sciences

2021  Volume 421, Page(s) 117308

Abstract: ... identified. Eleven patients had punctate susceptibility-weighted imaging (SWI) lesions in the subcortical and ... lesions in patients with severe COVID-19. Sixteen consecutive patients admitted to the intensive care unit ... with severe COVID-19 undergoing brain MRI for evaluation of coma or neurologic deficits were retrospectively ...

Abstract We evaluated the incidence, distribution, and histopathologic correlates of microvascular brain lesions in patients with severe COVID-19. Sixteen consecutive patients admitted to the intensive care unit with severe COVID-19 undergoing brain MRI for evaluation of coma or neurologic deficits were retrospectively identified. Eleven patients had punctate susceptibility-weighted imaging (SWI) lesions in the subcortical and deep white matter, eight patients had >10 SWI lesions, and four patients had lesions involving the corpus callosum. The distribution of SWI lesions was similar to that seen in patients with hypoxic respiratory failure, sepsis, and disseminated intravascular coagulation. Brain autopsy in one patient revealed that SWI lesions corresponded to widespread microvascular injury, characterized by perivascular and parenchymal petechial hemorrhages and microscopic ischemic lesions. Collectively, these radiologic and histopathologic findings add to growing evidence that patients with severe COVID-19 are at risk for multifocal microvascular hemorrhagic and ischemic lesions in the subcortical and deep white matter.
MeSH term(s) Brain/blood supply ; Brain/diagnostic imaging ; Brain Injuries/diagnostic imaging ; Brain Injuries/etiology ; COVID-19/complications ; COVID-19/diagnostic imaging ; Humans ; Intensive Care Units/trends ; Magnetic Resonance Imaging/methods ; Male ; Microvessels/diagnostic imaging ; Microvessels/injuries ; Middle Aged ; Retrospective Studies ; Severity of Illness Index
Language English
Publishing date 2021-01-15
Publishing country Netherlands
Document type Clinical Study
ZDB-ID 80160-4
ISSN 1878-5883 ; 0022-510X ; 0374-8642
ISSN (online) 1878-5883
ISSN 0022-510X ; 0374-8642
DOI 10.1016/j.jns.2021.117308
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