COVID-19 Neurologic Complication with CNS Vasculitis-Like Pattern

AJNR Am J Neuroradiol. 2020 Aug;41(8):1384-1387. doi: 10.3174/ajnr.A6651. Epub 2020 Jun 18.


Coronavirus disease 2019 (COVID-19) is a viral infection caused by the Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2), which spreads rapidly from person to person and manifests in most symptomatic patients as a respiratory illness, similar to prior SARS viruses. Neurologic manifestations of COVID-19 are uncommon; those so far reported include encephalopathy, stroke from large-vessel occlusion, and polyneuropathy. We report a unique neurologic complication of COVID-19 in a patient who had extensive cerebral small-vessel ischemic lesions resembling cerebral vasculitis in a characteristic combined imaging pattern of ischemia, hemorrhage, and punctuate postcontrast enhancement. Also, a characteristic lower extremity skin rash was present in our patient. Our observation lends support to the increasingly suspected mechanism of "endotheliitis" associated with this novel coronavirus.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Betacoronavirus*
  • COVID-19
  • Coronavirus Infections / complications*
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Multimodal Imaging
  • Pandemics
  • Pneumonia, Viral / complications*
  • SARS-CoV-2
  • Tomography, X-Ray Computed
  • Vasculitis, Central Nervous System / diagnostic imaging*
  • Vasculitis, Central Nervous System / etiology