Article Figures & Data
Figures
- FIG 1.
Examples of intracranial hemorrhages in patients with COVID-19. A, An axial noncontrast CT of a 42-year-old man demonstrates an acute intraparenchymal hematoma in the right cerebellar hemisphere, with severe mass effect and effacement of the fourth ventricle; multiple areas of layering hemorrhage are seen within the hematoma (arrow), suggestive of an underlying coagulopathy. B, Noncontrast CT of an 84-year-old woman after a fall shows scattered, curvilinear hyperdensities along the right superior frontal sulcus and left central sulcus, most consistent with acute subarachnoid hemorrhage. C, SWI of a 41-year-old man demonstrates scattered foci of susceptibility effect in the bilateral frontal and parietal lobes (arrow), most consistent with microhemorrhages.
- FIG 2.
Examples of acute infarcts in patients with COVID-19. Axial DWI (A) and corresponding apparent diffusion coefficient map (B) of a 50-year-old woman demonstrate restricted diffusion related to an acute left posterior cerebral artery territory infarction. The left temporo-occipital region (arrowhead), left hippocampus, and the left cerebral peduncle (arrow) are involved. Axial DWI (C) and ADC (D) images of a 24-year-old man shows a small, subtle focus of restricted diffusion in the right putamen (arrow), most consistent with an acute infarct.
- FIG 3.
Leukoencephalopathy in a 61-year-old man with COVID-19. Axial DWI (A) and apparent diffusion coefficient map (B) sequences are notable for extensive, confluent areas of restricted diffusion (arrow) that involve the bilateral centrum semiovale and corona radiata. (C) Corresponding T2 FLAIR hyperintensity is also seen.
Tables
- Table 1:
Comparison between patients with coronavirus disease 2019 with and without intracranial abnormalities
Acute Intracranial Abnormalities No Acute Intracranial Abnormalities Statistical Significance (P Value) Patients, n 26 124 Men/women, n 16/10 82/42 – Mean age, mean ± SD, y 63.6 ± 16 64 ± 16.5 ns (P = .896) Age range, y 24–87 22–96 – Body mass index ± SD, kg/m2 27.9 ± 5.3 28.5 ± 7.7 ns (P = .655) Length of stay ± SD (days) 24.9 ± 12.8 23.4 ± 16.9 ns (P = .091) Intensive care unit admission, % (n) 81.5 (22) 62.1 (77) (P = .039)a Intubation rate, % (n) 77.8 (21) 49.2 (61) (P = .004)b Acute kidney injury rate, % (n) 76.9 (20) 53.2 (66) (P = .030)a Mortality rate, % (n) 23.1 (6) 12.1 (15) ns (P = .209) Clinical Presentation n/N (%) Respiratory symptomsa 21/26 (81) Fever 7/26 (27) Headache 2/26 (8) Fall 2/26 (8) Stroke symptoms 2/26 (8) Multiple concerns 12/26 (46) Imaging indications Altered mental status 14/26 (54) Concern for infarct 8/26 (31) Concern for intracranial hemorrhage 1/26 (4) Hypoxia 1/26 (4) Seizure 1/26 (4) Headache 1/26 (4) Imaging findings Intracranial hemorrhage 11/26 (42) SAH 2/11 (18) Intraparenchymal hemorrhage 2/11 (18) Microhemorrhage 7/11 (64) Infarction 13/26 (50) ACA territory infarction 0/13 (0) MCA territory infarction 5/13 (38) PCA territory infarction 2/13 (15) PICA territory infarction 1/13 (8) Borderzone infarction 1/13 (8) Multiterritorial infarction 2/13 (15) Leukoencephalopathy 7/26 (27) Multiple abnormalities (infarction + hemorrhage) 4/26 (15) Note:—SAH indicates subarachnoid hemorrahge; ACA, anterior cerebral artery; MCA, middle cerebral artery; PCA, posterior cerebral artery; PICA, posterior inferior cerebellar artery.
↵aIncluding shortness of breath, respiratory distress, respiratory failure, and hypoxia.
