Imaging Features of Acute Encephalopathy in Patients with COVID-19: A Case Series

Fellows’ Journal Club

The authors present 5 cases that illustrate varying imaging presentations of acute encephalopathy in patients with coronavirus disease 2019. MR features include leukoencephalopathy, diffusion restriction that involves the GM and WM, microhemorrhages, and leptomeningitis.

Summary

An axial MR imaging of the brain of a 60-year-old man with COVID-19 who presented with disorientation and decreased alertness (case 2). A, A FLAIR image demonstrates diffuse confluent WM hyperintensity with sparing of the subcortical U-fibers (arrowheads). B, DWI shows corresponding restricted diffusion throughout the involved WM (arrowheads).

Coronavirus disease 2019 was declared a global pandemic by the World Health Organization on March 11, 2020. There is a scarcity of data on coronavirus disease 2019–related brain imaging features. We present 5 cases that illustrate varying imaging presentations of acute encephalopathy in patients with coronavirus disease 2019. MR features include leukoencephalopathy, diffusion restriction that involves the GM and WM, microhemorrhages, and leptomeningitis. We believe it is important for radiologists to be familiar with the neuroradiologic imaging spectrum of acute encephalopathy in the coronavirus disease 2019 population.

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