Transient cortical blindness in COVID-19 pneumonia; a PRES-like syndrome: Case report

Yıldız, Kaya; Kara, Simay; Akıncı, Canan; Kocaman, Ayşe Sağduyu

doi:10.1016/j.jns.2020.116858

Cited by 78 publications

(92 citation statements)

References 6 publications

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“…A 38-year-old man, infected with SARS-CoV-2, developed acute confusion with agitation and bilateral vision loss [ 94 ]. His brain MRI showed bilateral (especially left occipital, frontal cortical white matter, and splenium of corpus callosum) hyperintensities on FLAIR sequence indicating vasogenic edema similar to posterior reversible leukoencephalopathy.…”

Section: Cns Manifestations Associated With Covid-19mentioning

confidence: 99%

Central Nervous System Manifestations Associated with COVID-19

Divani

Andalib

Biller

et al. 2020

Curr Neurol Neurosci Rep

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Purpose of Review Coronavirus disease 2019 (COVID-19) has become a global health crisis of our time. The disease arises from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that binds to angiotensin-converting enzyme 2 (ACE2) receptors on host cells for its internalization. COVID-19 has a wide range of respiratory symptoms from mild to severe and affects several other organs, increasing the complexity of the treatment. There is accumulating evidence to suggest that SARS-CoV-2 can target the nervous system. In this review, we provide an account of the COVID-19 central nervous system (CNS) manifestations. Recent Findings A broad spectrum of the CNS manifestations including headache, impaired consciousness, delirium, loss of smell and taste, encephalitis, seizures, strokes, myelitis, acute disseminated encephalomyelitis, neurogenic respiratory failure, encephalopathy, silent hypoxemia, generalized myoclonus, neuroleptic malignant syndrome and Kawasaki syndrome has been reported in patients with COVID-19. Summary CNS manifestations associated with COVID-19 should be considered in clinical practice. There is a need for modification of current protocols and standing orders to provide better care for COVID-19 patients presenting with neurological symptoms.

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Section: Cns Manifestations Associated With Covid-19mentioning

confidence: 99%

Central Nervous System Manifestations Associated with COVID-19

Divani

Andalib

Biller

et al. 2020

Curr Neurol Neurosci Rep

View full text Add to dashboard Cite

show abstract

“…With the suspicion of acute cerebrovascular accident, he underwent brain MRI revealing bilateral occipital and frontal subcortical signal changes in T2/FLAIR and diffusion restriction in diffusion-weighted MRI. With a diagnosis of PRES, corticosteroid therapy was started leading to the complete recovery of the clinical symptoms on day 10 and the regression of MRI abnormalities on day 24 (13).…”

Section: Discussionmentioning

confidence: 99%

Posterior Reversible Encephalopathy Syndrome as a Rare Presentation of Coronavirus Disease 2019: A Case Report and Literature Review

Mozhdehipanah¹,

Paybast²,

Bahadori³

2020

J Vessel Circ

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The novel coronavirus (COVID-19) disease is a global pandemic of different severity ranging from a mild respiratory disease to a severe septic shock. The current evidence is suggestive of the neuroinvasive potential of this disease. However, there are limited reports regarding posterior reversible encephalopathy syndrome (PRES) as a neurological complication of COVID-19 in the literature. Herein, we aimed to present a case of PRES in association with COVID-19 and review the current reports in this regard. Case Report: This report presents a case of PRES complicated with intracerebral hemorrhage in a 39-year-old male with COVID-19, presenting with sudden blood pressure crisis accompanied by seizure and confusional state. Conclusion: Although the main clinical symptoms of COVID-19 are confined to the respiratory tract, the virus has the potential to target the brain, thereby inducing encephalitic syndrome, such as PRES.

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“…The authors postulated that the pathogenesis might be related to the "cytokine storm" induced by COVID-19 [81]. A posterior reversible encephalopathy-like syndrome, associated with transient cortical blindness, was also reported [64].…”

Section: Encephalopathymentioning

confidence: 99%

SARS-CoV-2 and the Nervous System: From Clinical Features to Molecular Mechanisms

Pennisi

Lanza

Falzone

et al. 2020

IJMS

131

129

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Increasing evidence suggests that Severe Acute Respiratory Syndrome-coronavirus-2 (SARS-CoV-2) can also invade the central nervous system (CNS). However, findings available on its neurological manifestations and their pathogenic mechanisms have not yet been systematically addressed. A literature search on neurological complications reported in patients with COVID-19 until June 2020 produced a total of 23 studies. Overall, these papers report that patients may exhibit a wide range of neurological manifestations, including encephalopathy, encephalitis, seizures, cerebrovascular events, acute polyneuropathy, headache, hypogeusia, and hyposmia, as well as some non-specific symptoms. Whether these features can be an indirect and unspecific consequence of the pulmonary disease or a generalized inflammatory state on the CNS remains to be determined; also, they may rather reflect direct SARS-CoV-2-related neuronal damage. Hematogenous versus transsynaptic propagation, the role of the angiotensin II converting enzyme receptor-2, the spread across the blood-brain barrier, the impact of the hyperimmune response (the so-called “cytokine storm”), and the possibility of virus persistence within some CNS resident cells are still debated. The different levels and severity of neurotropism and neurovirulence in patients with COVID-19 might be explained by a combination of viral and host factors and by their interaction.

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Transient cortical blindness in COVID-19 pneumonia; a PRES-like syndrome: Case report

Abstract: Fig. 3. On the second week of therapy DWI (a), ADC (b) and FLAIR (c) sequences showed complete regression of the lesions.

Cited by 78 publications

References 6 publications

Central Nervous System Manifestations Associated with COVID-19

Central Nervous System Manifestations Associated with COVID-19

Posterior Reversible Encephalopathy Syndrome as a Rare Presentation of Coronavirus Disease 2019: A Case Report and Literature Review

SARS-CoV-2 and the Nervous System: From Clinical Features to Molecular Mechanisms

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