背景:在COVID-19大流行期间,在全球范围内已经报道了这种感染的患者的各种并发症,包括广泛的神经系统疾病。在这项研究中,我们报道了一例46岁女性的新神经系统并发症,该女性因轻度COVID-19感染后头痛而转诊.此外,我们对以前关于COVID-19患者的硬脑膜和软脑膜受累的报道进行了快速回顾.
方法:患者头痛持续,全球,并对眼睛产生辐射。头痛的严重程度在病程中增加,并因步行而加剧,咳嗽,打喷嚏,但随着休息而减少。严重的头痛扰乱了患者的睡眠。神经系统检查完全正常,除了炎症模式外,实验室检查没有异常发现。最后,在大脑核磁共振成像中,同时观察到弥漫性硬脑膜增强和软脑膜受累,这是COVID-19患者的新发现,到目前为止还没有报道。患者住院并接受甲基强的松龙脉冲治疗。完成疗程后,她身体状况良好,头痛有所改善,出院后出院。出院后2个月要求重复进行脑部MRI检查,这是完全正常的,没有显示硬脑膜和软脑膜受累的证据。
结论:COVID-19引起的中枢神经系统炎症并发症可以以不同的形式和类型发生,临床医生应该考虑。
BACKGROUND: During the COVID-19 pandemic, various complications have been reported in patients with this infection worldwide, including a wide range of neurological disorders. In this study, we have reported a novel neurological complication in a 46-years-old woman who was referred due to a headache following a mild COVID-19 infection. Also, we have had a quick review of previous reports of dural and leptomeningeal involvements in COVID-19 patients.
METHODS: The patient\'s headache was persistent, global, and compressive with radiation to the eyes. The severity of the headache was increased during the disease course and was exacerbated by walking, coughing, and sneezing but decreased with rest. The high severity of the headache disrupted the patient\'s sleep. Neurological examinations were completely normal, and laboratory tests did not have abnormal findings except for an inflammatory pattern. Finally, in the brain MRI, a concurrent diffuse dural enhancement and leptomeningeal involvement were observed, which is a new finding in COVID-19 patients and has not been reported so far. The patient was hospitalized and treated with Methylprednisolone pulses. After completing the therapeutic course, she was discharged from the hospital in good condition and with an improved headache. A repeated brain MRI was requested 2 months after discharge, which was completely normal and showed no evidence of dural and leptomeningeal involvements.
CONCLUSIONS: Inflammatory complications of the central nervous system caused by COVID-19 can occur in different forms and types, and clinicians should consider them.