PT  - JOURNAL ARTICLE
AU  - Ida Petersson
AU  - Bjorn M Hansen
AU  - Anders Svenningsson
AU  - Annika Lundstrom
TI  - Cerebral microvascular injuries in severe COVID-19 infection: progression of white matter hyperintensities post-infection
AID  - 10.1136/bcr-2022-249156
DP  - 2022 Sep 01
TA  - BMJ Case Reports
PG  - e249156
VI  - 15
IP  - 9
4099  - http://casereports.bmj.com/content/15/9/e249156.short
4100  - http://casereports.bmj.com/content/15/9/e249156.full
SO  - BMJ Case Reports2022 Sep 01; 15
AB  - A range of neuroradiological findings has been reported in patients with COVID-19, some mimicking cerebral small vessel disease (CSVD). We present a case of a man in his 50s with severe COVID-19, who was Glasgow Coma Scale 3 and tetraparetic after sedation was ceased in the intensive care unit. Return of consciousness and motor activity was slow. An MRI 1 month after debut of symptoms demonstrated white matter hyperintensities on T2-weighted Fluid Attenuated Inversion Recovery (T2-FLAIR) and many small areas with impaired diffusion in primarily supratentorial and infratentorial white matter on Diffusion-Weighted Imaging (DWI). In the following months, the patient made a remarkable clinical recovery. Despite clinical improvement, an MRI after 7 months showed that white matter hyperintensities had progressed and become confluent. Both MRIs demonstrated findings resembling CSVD, which could relate to a COVID-19-specific process affecting cerebral microvasculature.