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Possible affective cognitive cerebellar syndrome in a young patient with COVID-19 CNS vasculopathy and stroke
  1. Kai Xin Chia1,
  2. Sonali Polakhare1 and
  3. Stefania Dafne Bruno1,2
  1. 1Blackheath Brain Injury Rehabilitation Centre, London, UK
  2. 2IOPPN, King's College London, London, UK
  1. Correspondence to Dr Stefania Dafne Bruno; dr.stefania.bruno{at}


Early case series suggest that about one-third of patients with COVID-19 present with neurological manifestations, including cerebrovascular disease, reported in 2%–6% of hospitalised patients. These are generally older patients with severe infection and comorbidities. Here we discuss the case of a previously fit and well 39-year-old man who presented with fever and respiratory symptoms, evolving in pneumonia with hypoxia but only requiring continuous positive airway pressure. After resolution of the respiratory disease, the patient developed focal neurology and was found to have bilateral occipital, thalamic and cerebellar infarcts. A diagnosis of COVID-19 central nervous system vasculopathy was made. He developed a florid neuropsychiatric syndrome, including paranoia, irritability, aggression and disinhibition, requiring treatment with antipsychotics and transfer to neurorehabilitation. Neuropsychometry revealed a wide range of cognitive deficits. The rapid evolution of the illness was matched by fast resolution of the neuropsychiatric picture with mild residual cognitive impairment.

  • rehabilitation medicine
  • brain stem / cerebellum
  • stroke
  • psychiatry

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  • Contributors KXC and SP have contributed in equal measure to this work. All authors have been involved in the design, planning, drafting and discussion of the article. SDB and SP have been involved in the clinical management of the patient. KXC has carried out the neuropsychometry testing.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.