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Research ArticleAdult Brain
Open Access

COVID-19 Neurologic Complication with CNS Vasculitis-Like Pattern

R. Hanafi, P.-A. Roger, B. Perin, G. Kuchcinski, N. Deleval, F. Dallery, D. Michel, L. Hacein-Bey, J.-P. Pruvo, O. Outteryck and J.-M. Constans
American Journal of Neuroradiology August 2020, 41 (8) 1384-1387; DOI: https://doi.org/10.3174/ajnr.A6651
R. Hanafi
aFrom the Department of Neuroradiology (R.H., G.K., J.-P.P., O.O.), University Hospital of Lille, Hôpital Roger Salengro, Lille, France
bDepartments of Interventional Radiology (R.H.), Cardiothoracic, Vascular and Respiratory Intensive Care (P.-A.R.), Neurology and Neurophysiology (B.P.), and Neuroradiology (N.D., F.D., D.M., J.-M.C.), University Hospital of Amiens, Amiens, France
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P.-A. Roger
bDepartments of Interventional Radiology (R.H.), Cardiothoracic, Vascular and Respiratory Intensive Care (P.-A.R.), Neurology and Neurophysiology (B.P.), and Neuroradiology (N.D., F.D., D.M., J.-M.C.), University Hospital of Amiens, Amiens, France
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B. Perin
bDepartments of Interventional Radiology (R.H.), Cardiothoracic, Vascular and Respiratory Intensive Care (P.-A.R.), Neurology and Neurophysiology (B.P.), and Neuroradiology (N.D., F.D., D.M., J.-M.C.), University Hospital of Amiens, Amiens, France
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G. Kuchcinski
aFrom the Department of Neuroradiology (R.H., G.K., J.-P.P., O.O.), University Hospital of Lille, Hôpital Roger Salengro, Lille, France
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N. Deleval
bDepartments of Interventional Radiology (R.H.), Cardiothoracic, Vascular and Respiratory Intensive Care (P.-A.R.), Neurology and Neurophysiology (B.P.), and Neuroradiology (N.D., F.D., D.M., J.-M.C.), University Hospital of Amiens, Amiens, France
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F. Dallery
bDepartments of Interventional Radiology (R.H.), Cardiothoracic, Vascular and Respiratory Intensive Care (P.-A.R.), Neurology and Neurophysiology (B.P.), and Neuroradiology (N.D., F.D., D.M., J.-M.C.), University Hospital of Amiens, Amiens, France
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D. Michel
bDepartments of Interventional Radiology (R.H.), Cardiothoracic, Vascular and Respiratory Intensive Care (P.-A.R.), Neurology and Neurophysiology (B.P.), and Neuroradiology (N.D., F.D., D.M., J.-M.C.), University Hospital of Amiens, Amiens, France
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L. Hacein-Bey
cDepartments of Neuroradiology and Radiology (L.H.-B.), University of California Davis School of Medicine, Sacramento, California.
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J.-P. Pruvo
aFrom the Department of Neuroradiology (R.H., G.K., J.-P.P., O.O.), University Hospital of Lille, Hôpital Roger Salengro, Lille, France
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O. Outteryck
aFrom the Department of Neuroradiology (R.H., G.K., J.-P.P., O.O.), University Hospital of Lille, Hôpital Roger Salengro, Lille, France
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J.-M. Constans
bDepartments of Interventional Radiology (R.H.), Cardiothoracic, Vascular and Respiratory Intensive Care (P.-A.R.), Neurology and Neurophysiology (B.P.), and Neuroradiology (N.D., F.D., D.M., J.-M.C.), University Hospital of Amiens, Amiens, France
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    Fig 1.

    Noncontrast brain CT of presumptive COVID-associated small-vessel injury. Note deep white matter (A), basal ganglia (B), and cerebellar (C) hypodensities (arrows). Bilateral globus pallidus hemorrhage is also present (B, arrows).

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    Fig 2.

    T2*-weighted MR imaging demonstrates bilateral globus pallidus susceptibility, consistent with microhemorrhage (arrows).

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    Fig 3.

    Diffuse deep white matter ischemic injuries. DWI shows numerous focal ischemic lesions within the hemispheric deep white matter (A, white arrow), the corpus callosum (A, red arrow), the basal ganglia, the middle cerebellar peduncles, and the cerebellar hemispheres (B, white arrows).

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    Fig 4.

    Diffuse ischemic lesions on FLAIR imaging. Axial (A–C) and coronal (D) FLAIR images show hyperintense ischemic lesions within the periventricular white matter, basal ganglia, cerebellar peduncles (white arrows), and the corpus callosum (A, red arrow).

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    Fig 5.

    Patchy/punctate postcontrast enhancement pattern with consistent small vessel involvement. Postcontrast T1 MR imaging shows intense patchy enhancement of all lesions, in particular the globus pallidus bilaterally (A, white arrows), with a punctuate pattern in the middle cerebellar peduncles and cerebellar hemispheres (B, arrow).

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    Fig 6.

    Coronal 3D reconstruction MRA of the supra-aortic arteries shows no detectable abnormality of large intra- or extracranial vessels.

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American Journal of Neuroradiology: 41 (8)
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Cite this article
R. Hanafi, P.-A. Roger, B. Perin, G. Kuchcinski, N. Deleval, F. Dallery, D. Michel, L. Hacein-Bey, J.-P. Pruvo, O. Outteryck, J.-M. Constans
COVID-19 Neurologic Complication with CNS Vasculitis-Like Pattern
American Journal of Neuroradiology Aug 2020, 41 (8) 1384-1387; DOI: 10.3174/ajnr.A6651

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COVID-19 Neurologic Complication with CNS Vasculitis-Like Pattern
R. Hanafi, P.-A. Roger, B. Perin, G. Kuchcinski, N. Deleval, F. Dallery, D. Michel, L. Hacein-Bey, J.-P. Pruvo, O. Outteryck, J.-M. Constans
American Journal of Neuroradiology Aug 2020, 41 (8) 1384-1387; DOI: 10.3174/ajnr.A6651
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