Normal pressure hydrocephalus associated with COVID-19 infection: a case report

Vasconcelos, Thaís de Maria Frota; Nóbrega, Paulo Ribeiro; Ferreira, Glauber de Menezes; Souza, Moysés Loiola Ponte de; Vanderlei, Alander Sobreira; Castro, Jaelson; Braga‐Neto, Pedro; Sobreira-Neto, Manoel Alves

doi:10.1186/s12879-022-07184-x

Cited by 9 publications

(12 citation statements)

References 15 publications

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“…To our knowledge there are no other cases reported in the literature of an NPH worsening shortly before the evidence of SARS-CoV-2 infection. Other authors reported cases of patients with "delayed" development of NPH after COVID-19 (one week three months from infection), requiring surgery for the treatment of the hydrocephalus [11][12][13]. All these patients did not have other risk factors for NPH or significant medical history apart from a recent SARS-CoV-2 infection.…”

Section: Discussionmentioning

confidence: 98%

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Hydrocephalus As Possible Prodromal Manifestation of COVID-19: A Report of Two Cases

Torelli¹,

Severino²,

Caggiano³

et al. 2023

Cureus

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Although the etiopathology of normal pressure hydrocephalus (NPH) is still not completely defined, several studies in recent years have highlighted the role of neuro-inflammation mediators in its development.During COVID-19, the infected host develops a multifaceted inflammatory syndrome, that may lead to an uncontrolled immune system response also localized in the host nervous system. In fact, the target of the viral Spike protein, the angiotensin-converting enzyme 2 (ACE2) receptors, is widely expressed in different areas of CNS such as the olfactory epithelium, and the choroid plexus. As for idiopathic NPH, the massive release of inflammatory mediators may result in altered CSF dynamics and consequent sudden clinical decompensation.We report the cases of two patients with a known iNPH condition, in which neurological symptoms suddenly worsened, requiring hospitalization, without any evident precipitating cause. Both patients tested positive for the COVID-19 virus shortly after the neurological impairment, which had occurred, therefore, during the incubation period of the infection.On the basis of our experience we advise, in cases of NPH patients with sudden neurological worsening, to perform a molecular COVID-19 swab at the moment of clinical impairment. We, therefore, recommend considering SARS-CoV-2 infection in the differential diagnosis of a sudden and otherwise unexplainable impairment of hydrocephalic patients. Furthermore, we believe clinicians should invite NPH patients to adopt adequate preventive measures to protect them from SARS-CoV-2 infection.

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Section: Discussionmentioning

confidence: 98%

“…Since the beginning of the SARS-CoV-2 pandemic only three cases of previously healthy patients who developed NPH after COVID-19 infection have been described [11][12][13], suggesting that NPH may have been a complication of the neuro-inflammation response triggered by SARS-CoV2 in the nervous system.…”

Section: Introductionmentioning

confidence: 99%

Hydrocephalus As Possible Prodromal Manifestation of COVID-19: A Report of Two Cases

Torelli¹,

Severino²,

Caggiano³

et al. 2023

Cureus

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“…There is an ever-growing list of diseases allegedly associated with COVID-19, which includes esoteric case reports describing SARS-CoV-2 - varicella-zoster meningitis coinfection 36 , COVID-19-associated vestibulopathy 37 , nasopharyngeal swab-associated carotid-artery dissection with retinal ischemia 38 , normal pressure hydrocephalus 39 , cerebral vasculitis 40 , and many other rare neurological syndromes. This list even includes diseases with well-known pathophysiological mechanisms, such as neurodegenerative 41 , metabolic 42 , autoimmune 43 , and infectious 44 diseases.…”

Section: Neurological Complications Associated With Acute Sars-cov-2 ...mentioning

confidence: 99%

NeuroCOVID-19: a critical review

Guedes

2022

Arq. Neuro-Psiquiatr.

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Background: The COVID-19 pandemic has challenged neurologists since its early days. Neurology consultation services were then overloaded by emergency department and intensive-care patients with acute neurological syndromes. These complications are better explained today, but the growing number of patients with reported longstanding neurological symptoms constitute an emerging, complex, and still poorly understood phenomenon. Objective: This review summarizes data on relevant neurological manifestations of acute SARS-CoV-2 infection and lasting post-infectious disease, also known as Long COVID. The complex history of Long COVID is examined to illustrate the upsides and challenges imposed by the active participation of patient communities in the production of medical knowledge. Methods: Narrative review. Results: Infection with the severe acute respiratory syndrome coronavirus 2 is associated with encephalopathy/delirium, cerebrovascular disease, headache, and peripheral nervous system involvement. Long COVID is a living concept jointly defined by patient communities, physicians and scientists, including neurologists. Conclusion: Co-production of Long COVID knowledge between scientists and patients has initiated an era of patient-led research and evidence-based activism that acts as a two-edged sword - putting patient’s suffering in the spotlight, but with a tradeoff in methodological consistency.

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“…Along these lines, we present the case of a 48-year-old male who developed normal pressure hydrocephalus (NPH) shortly after a COVID-19 infection. As per our literature review, there has been only one other similar case report published about NPH associated with COVID-19 infection [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

A Case Report of Normal Pressure Hydrocephalus Developing After COVID-19 Infection

Badar¹,

Cheema²,

Iftikhar³

2023

Cureus

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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 virus) has been reported to cause significant injury to the central nervous system (CNS). Herein, we describe the case of a 48-year-old male with a past medical history of attention-deficit/hyperactivity disorder (ADHD), hypertension, and hyperlipidemia who developed typical symptomatology of normal pressure hydrocephalus (NPH) with cognitive impairment, gait dysfunction, and urinary incontinence after a mild coronavirus disease (COVID-19) infection. The diagnosis was confirmed by imaging and lumbar puncture (LP). The patient was treated with a ventriculoperitoneal (VP) shunt placed by neurosurgery and had a complete recovery.Despite increasing reports of neurological manifestations of COVID-19 infection, the mechanism of such pathology is still not well understood. Hypotheses include viral invasion of the CNS either through the nasopharynx and olfactory epithelium or directly through the blood brain barrier.

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Normal pressure hydrocephalus associated with COVID-19 infection: a case report

Cited by 9 publications

References 15 publications

Hydrocephalus As Possible Prodromal Manifestation of COVID-19: A Report of Two Cases

Hydrocephalus As Possible Prodromal Manifestation of COVID-19: A Report of Two Cases

NeuroCOVID-19: a critical review

A Case Report of Normal Pressure Hydrocephalus Developing After COVID-19 Infection

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