COVID-19-related disseminated Leukoencephalopathy on brain M
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According to an article by the American Journal of Roentgenology, Covid-19 related disseminated leukoencephalopathy (CRDL) represents an important-albeit uncommon-differential consideration in patients with neurologic manifestations of Covid-19.

Coronavirus disease (COVID-19) is well known to cause multi-focal pneumonia. Increasingly, effects of COVID-19 on the brain are being reported, including acute necrotizing encephalopathy, infarcts, microhemorrhage, acute disseminated encephalomyelitis, and leukoencephalopathy

Among 2820 patients with COVID-19, 59 underwent brain MRI. Three had known white matter lesions from multiple sclerosis, 23 had white matter lesions of small vessel ischemic disease, six had acute infarcts, four had subacute infarcts, four had chronic infarcts, one had abnormal basal ganglia signal from hypoxemia, two had microhemorrhage in association with chronic infarcts, and two had microhemorrhage associated with acute or subacute infarcts.

Of them, six had MRI findings suspicious for COVID-19–related disseminated leukoencephalopathy (CRDL), which is characterized by extensive confluent or multifocal white matter lesions, microhemorrhages, diffusion restriction, and enhancement. Hypertension and type 2 diabetes mellitus were common comorbidities.

In particular, although no established criteria exist for defining CRDL, the patients had white matter lesions atypical for other causes, such as hypoxic injury, delayed post hypoxic leukoencephalopathy, chronic small vessel ischemic disease, and infarction, and had involvement of the bilateral middle cerebellar peduncles and corpus callosum.

Source: https://www.ajronline.org/doi/10.2214/AJR.20.24364
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