COVID-19-related diffuse leukoencephalopathy with microbleeds and persistent coma: a case report with good clinical outcome.
Elbert Hans WitvoetFeng Yan JiangWillemijn LaumansSebastiaan Franciscus Titus Maria de BruijnPublished in: BMJ case reports (2021)
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.
Keyphrases
- coronavirus disease
- sars cov
- case report
- poor prognosis
- cardiac arrest
- long non coding rna
- low grade
- chronic pain
- magnetic resonance imaging
- respiratory syndrome coronavirus
- intensive care unit
- magnetic resonance
- contrast enhanced
- pain management
- white matter
- blood brain barrier
- combination therapy
- drug induced
- mechanical ventilation