1. Cerebral vasculitis of medium-sized vessels as a possible mechanism of brain damage in COVID-19 patients.
- Author
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Lersy F, Anheim M, Willaume T, Chammas A, Brisset JC, Cotton F, and Kremer S
- Subjects
- Adult, Aged, Aged, 80 and over, COVID-19 diagnostic imaging, Female, Humans, Magnetic Resonance Angiography, Magnetic Resonance Imaging, Male, Middle Aged, Neuroimaging, Retrospective Studies, Vasculitis, Central Nervous System diagnostic imaging, Young Adult, Brain diagnostic imaging, COVID-19 complications, Vasculitis, Central Nervous System etiology
- Abstract
Background and Purpose: Cerebral complications related to COVID-19 were recently reported, and the underlying mechanisms of brain damage remain uncertain, probably multifactorial. Among various hypotheses suggested, a possible vasculitis was issued but never confirmed. Herein, we aimed to describe brain MRIs focused on the intracranial vessel wall in a population of COVID-19 patients with neurologic manifestations., Materials and Methods: Between March 1 and May 31, 2020, 69 consecutive COVID-19 patients with neurologic manifestations underwent a brain MRI allowing the study of the intracranial vessel wall at Strasbourg University hospitals and were retrospectively included. During the same period, 25 consecutive patients, without suspicion of SARS-CoV-2 infection, underwent a brain MRI urgently, with the same imaging protocols. A vasculitis seemed likely when imaging demonstrated vessel wall thickening with homogeneous and concentric enhancement., Results: Among the 69 COVID-19 patients included, 11 (16%) presented arterial vessel wall thickening with homogeneous and concentric enhancement, compatible with cerebral vasculitis. These neuroimaging findings were not found among the 25 patients without SARS-CoV-2 infection, and the difference was statistically significant (p = 0.03). Middle cerebral arteries, basilar artery, and posterior cerebral arteries were the most frequent vessels involved. For nine of them, imaging demonstrated ischemic or hemorrhagic complications., Conclusion: Cerebral vasculitis of medium-sized vessels seems to be one of the mechanisms at the origin of brain damage related to COVID-19., (Copyright © 2020 Elsevier Masson SAS. All rights reserved.)
- Published
- 2021
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