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首页> 外文期刊>The Canadian Journal of Neurological Sciences: le Journal Canadien des Sciences Neurologiques >COVID-19 Associated Central Nervous System Vasculopathy
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COVID-19 Associated Central Nervous System Vasculopathy

机译：Covid-19相关中枢神经系统血管病变

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摘要

A 42-year-old man presented to the emergency department with fever, asthenia, myalgias, dry cough, and hyposmia. After detection of viral nucleic acid from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a nasopharyngeal swab, the diagnosis of coronavirus disease 2019 (COVID-19) was made. As there were no severe criteria for admittance, the patient was discharged on symptomatic medication.One week later, he was brought to the hospital due to altered mental status, slowness of movements, and apathy. Neurological examination revealed dysexecutive syndrome, perseveration, and mild dysphonia/dysphagia; there were no pyramidal/extra-pyramidal signs. Blood work-up was unremarkable, and brain computed tomography (CT) showed multiple hypodense lesions involving the white matter, basal ganglia, and thalami. Lumbar puncture revealed mild elevated proteins (0.78 mg/dL) without pleocytosis; cerebrospinal fluid (CSF) viral workup was negative, including S ARS-CoV-2. Extensive serological immune and infective panels were negative. Suspecting an inflammatory response related to SARS-CoV-2 infection, intravenous immunoglobulin (30g/day) was initiated.
机译：一名42岁男子因发热、乏力、肌痛、干咳和嗅觉减退被送往急诊室。在鼻咽拭子中检测到来自严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的病毒核酸后，诊断为2019年冠状病毒病（COVID-19）。由于没有严格的准入标准，患者服用了有症状的药物后出院。一周后，由于精神状态改变、行动迟缓和冷漠，他被送往医院。神经系统检查显示执行障碍综合征、持续性和轻度发音困难/吞咽困难；没有锥体/锥体外系迹象。血液检查不明显，脑计算机断层扫描（CT）显示多处低密度病变，累及白质、基底节和丘脑。腰椎穿刺显示蛋白轻度升高（0.78 mg/dL），无细胞增多；脑脊液（CSF）病毒检查呈阴性，包括S ARS-CoV-2。广泛的血清学免疫组和感染组均为阴性。怀疑SARS-CoV-2感染相关的炎症反应，开始静脉注射免疫球蛋白（30g/天）。

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