Cerebral vasculitis of medium-sized vessels as a possible mechanism of brain damage in COVID-19 patients - 04/05/21
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Graphical abstract |
Highlights |
• | Intracranial vessel wall imaging appears useful in COVID-19 patients. |
• | Vasculitis seems likely as imaging demonstrated vessel wall thickening with homogeneous and concentric enhancement. |
• | Cerebral vasculitis seems to be one of the mechanisms at the origin of brain damage related to COVID-19. |
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.
Le texte complet de cet article est disponible en PDF.Abbreviations : RT-PCR, VZV
Keywords : Vasculitis, COVID-19, Magnetic Resonance Imaging (MRI)
Plan
Vol 48 - N° 3
P. 141-146 - mai 2021 Retour au numéro
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