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  • COVID-19-related diffuse leukoencephalopathy with microbleeds and persistent coma: a case report with good clinical outcome

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Case report
COVID-19-related diffuse leukoencephalopathy with microbleeds and persistent coma: a case report with good clinical outcome
  1. Elbert Hans Witvoet1,
  2. Feng Yan Jiang2,
  3. Willemijn Laumans3 and
  4. Sebastiaan Franciscus Titus Maria de Bruijn1
  1. 1Department of Neurology, Haga Hospital, Den Haag, The Netherlands
  2. 2Department of Radiology, Haga Hospital, Den Haag, The Netherlands
  3. 3Department of Intensive Care Medicine, Haga Hospital, Den Haag, The Netherlands
  1. Correspondence to Dr Elbert Hans Witvoet; elbertwitvoet{at}gmail.com

Abstract

A 60-year-old patient presented with respiratory distress, after recently being tested COVID-19 positive and was mechanically ventilated for 15 days. After cessation of sedation, he remained in deep comatose state, without any reaction on pain stimuli (Glasgow Coma Score 3). MRI of the brain showed diffuse leukoencephalopathy and multiple (>50) microbleeds. Diffuse COVID-19-associated leukoencephalopathy with microhaemorrhages is associated with a poor prognosis. However, 3 months later, our patient showed a remarkable recovery and was able to walk independently. This case report shows COVID-related leukoencephalopathy and intracerebral microbleeds, even with persistent comatose state, may have a favourable clinical outcome and prolonged treatment should be considered in individual cases.

  • COVID-19
  • coma and raised intracranial pressure

This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

https://bmj.com/coronavirus/usage

https://doi.org/10.1136/bcr-2021-242504

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    Footnotes

    • Contributors EHW initiated the project, drafted and revised the paper. FYJ drafted and revised the papier. WL drafted and revised the paper. SFTMdB initiated the project and revised the paper.

    • 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.

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