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Article Dans Une Revue Journal de Neuroradiologie / Journal of Neuroradiology Année : 2021

Cerebral vasculitis of medium-sized vessels as a possible mechanism of brain damage in COVID-19 patients

Résumé

Background and purpose: Cerebral complications related to COVID-19 were recently reported, and the underlying mechanisms of brain damage remain uncertain, probably multifactorial. Among various hypotheses suggested, a possible vasculitis was issued but never confirmed. Herein, we aimed to describe brain MRIs focused on the intracranial vessel wall in a population of COVID-19 patients with neurologic manifestations.Materials and methods: Between March 1 and May 31, 2020, 69 consecutive COVID-19 patients with neurologic manifestations underwent a brain MRI allowing the study of the intracranial vessel wall at Strasbourg University hospitals and were retrospectively included. During the same period, 25 consecutive patients, without suspicion of SARS-CoV-2 infection, underwent a brain MRI urgently, with the same imaging protocols. A vasculitis seemed likely when imaging demonstrated vessel wall thickening with homogeneous and concentric enhancement.Results: Among the 69 COVID-19 patients included, 11 (16%) presented arterial vessel wall thickening with homogeneous and concentric enhancement, compatible with cerebral vasculitis. These neuroimaging findings were not found among the 25 patients without SARS-CoV-2 infection, and the difference was statistically significant (p = 0.03). Middle cerebral arteries, basilar artery, and posterior cerebral arteries were the most frequent vessels involved. For nine of them, imaging demonstrated ischemic or hemorrhagic complications.Conclusion: Cerebral vasculitis of medium-sized vessels seems to be one of the mechanisms at the origin of brain damage related to COVID-19.
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hal-03708086 , version 1 (09-05-2023)

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Paternité - Pas d'utilisation commerciale

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François Lersy, Mathieu Anheim, Thibault Willaume, Agathe Chammas, Jean-Christophe Brisset, et al.. Cerebral vasculitis of medium-sized vessels as a possible mechanism of brain damage in COVID-19 patients. Journal de Neuroradiologie / Journal of Neuroradiology, 2021, 48 (3), pp.141-146. ⟨10.1016/j.neurad.2020.11.004⟩. ⟨hal-03708086⟩
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