Splenium of the Corpus Callosum Infarct Associated With COVID-19: Case Report.


Journal

The neurologist
ISSN: 2331-2637
Titre abrégé: Neurologist
Pays: United States
ID NLM: 9503763

Informations de publication

Date de publication:
01 Jul 2023
Historique:
medline: 10 7 2023
pubmed: 1 9 2022
entrez: 31 8 2022
Statut: epublish

Résumé

Coronavirus disease 2019 (COVID-19) has been recently associated with infarction of the central splenium of the corpus callosum. These are described as cytotoxic lesions, and imaging rarely reveals enhancement. They have not been described in the body or head of the corpus callosum. Few diseases affect the corpus callosum, but the most common include multiple sclerosis, aquaporin-4 disease, and Susac syndrome. There is also emerging literature on Mild Encephalopathy with Reversible Splenial lesions associated with central and not basal lesions. The reason for the location of these lesions in acute COVID-19 infection is unknown. A 22-year-old female presented to the ED for altered mental status after being found down. A brief history review indicated that the patient had been altered for 2-3 days before being found naked and covered in her own feces and urine by her family after they had not heard from her. As she lived alone, a clear history of the events preceding her admission remains unclear. On initial assessment, the patient was found to be somnolent and nonverbal, though she could follow simple commands. On admission, testing for SARS CoV-2 RNA PCR was positive. Patient was admitted to the hospital for further work up to determine the cause of the altered mental status. We present a new case of a young woman who developed a central splenium lesion during acute COVID-19 infection and explain the predilection for the callosum in these patients, as well as literature to show that COVID-19 was most likely the cause.

Identifiants

pubmed: 36044912
doi: 10.1097/NRL.0000000000000466
pii: 00127893-990000000-00037
doi:

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

244-246

Informations de copyright

Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.

Déclaration de conflit d'intérêts

The authors declare no conflict of interest.

Références

Forestier G, de Beaurepaire I, Bornet G, et al. Cytotoxic lesion of the corpus callosum as presenting neuroradiological manifestation of COVID-2019 infection. J Neurol. 2020;268:1595–1597.
Yuan J, Yang S, Wang S, et al. Mild encephalitis/encephalopathy with reversible splenial lesion (MERS) in adults-a case report and literature review. BMC Neurol. 2017;17:103.
Hoshino A, Saitoh M, Oka A, et al. Epidemiology of acute encephalopathy in Japan, with emphasis on the association of viruses and syndromes. Brain Dev. 2012;34:337–343.
Moonis G, Filippi CG, Kirsch CFE, et al. The spectrum of neuroimaging findings on CT and MRI in adults with Coronavirus Disease (COVID-19). AJR Am J Roentgenol. 2020;217:959–974.
Sawlani V, Scotton S, Nader K, et al. COVID-19-related intracranial imaging findings: a large single centre experience. Clin Radiol. 2021;76:108–116.
Gaur P, Dixon L, Jones B, et al. COVID-19-associated cytotoxic lesions of the corpus callosum. AJNR Am J Neuroradiol. 2020;41:1905–1907.
Susac JO, Murtagh FR, Egan RA, et al. MRI findings in susac syndrome. Neurology. 2003;61:1783–1787.
Egan RA. Diagnostic criteria and treatment algorithm for susac syndrome. J Neuro-Ophthalmol. 2019;39:60–67.
Tusheva I, Damevska K, Dimitrovska I, et al. Unilateral livedo reticularis in a COVID- 19 patient: case with fatal outcome. JAAD Case Rep. 2021;7:120–121.
Manalo IF, Smith MK, Cheeley J, et al. A dermatologic manifestation of COVID- 19: Transient livedo reticularis. J Am Acad Dermatol. 2020;83:700.

Auteurs

David A Karp (DA)

Alameda Highland Hospital, Department of Neurology, Oakland, CA.

Gabriel Beaudoin (G)

Alameda Highland Hospital, Department of Neurology, Oakland, CA.
Sutter California Pacific Medical Center, Department of Psychiatry, San Francisco, CA.

Robert A Egan (RA)

Alameda Highland Hospital, Department of Neurology, Oakland, CA.
Sutter California Pacific Medical Center, Department of Neurology, San Francisco, CA.
Providence Medford Medical Center, Department of Neurology, Medford, OR.

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