Neuroradiologic Imaging of Neurologic and Neuro-Ophthalmic Complications of Coronavirus-19 Infection.

J Neuroophthalmol

Department of Radiology (M. Marsiglia), Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Department of Neurology (BKC), Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Department of Ophthalmology (BKC), Massachusetts Eye & Ear, Harvard Medical School, Boston, Massachusetts; and Department of Radiology/Division of Neuroradiology (M. Maher), University of Pennsylvania Medical Center, Philadelphia, Pennsylvania.

Published: December 2021

AI Article Synopsis

  • - This review examines the neurological and neuro-ophthalmic complications linked to COVID-19, drawing from a comprehensive analysis of existing literature.
  • - Key complications include various disorders related to the visual pathways and central nervous system, such as optic neuritis, encephalitis, and thromboembolism, each identified through specific imaging findings.
  • - Ongoing research aims to understand the diverse manifestations and long-term effects of COVID-19 on the nervous system, which is critical for effective treatment and understanding the disease's mechanisms.

Article Abstract

Background: To review the literature and provide a summary of COVID-19-related neurologic and neuro-ophthalmic complications.

Methods: The currently available literature was reviewed on PubMed and Google Scholar using the following keywords for searches: CNS, Neuro-Ophthalmology, COVID-19, SARS-CoV-2, coronavirus, optic neuritis, pseudotumor cerebri, Acute Disseminated Encephalomyelitis, posterior reversible encephalopathy syndrome (PRES), meningitis, encephalitis, acute necrotizing hemorrhagic encephalopathy, and Guillain-Barré and Miller Fisher syndromes.

Results: Neuroradiologic findings of neurologic and neuro-ophthalmologic complications in relationship to COVID-19 infection were reviewed. Afferent visual pathway-related disorders with relevant imaging manifestations included fundus nodules on MRI, papilledema and pseudotumor cerebri syndrome, optic neuritis, Acute Disseminated Encephalomyelitis, vascular injury with thromboembolism and infarct, leukoencephalopathy, gray matter hypoxic injury, hemorrhage, infectious meningitis/encephalitis, acute necrotizing hemorrhagic encephalopathy, and PRES. Efferent visual pathway-related complications with relevant imaging manifestations were also reviewed, including orbital abnormalities, cranial neuropathy, Guillain-Barré and Miller Fisher syndromes, and nystagmus and other eye movement abnormalities related to rhombencephalitis.

Conclusion: COVID-19 can cause central and peripheral nervous system disease, including along both the afferent and efferent components of visual axis. Manifestations of disease and long-term sequela continue to be studied and described. Familiarity with the wide variety of neurologic, ophthalmic, and neuroradiologic presentations can promote prompt and appropriate treatment and continue building a framework to understand the underlying mechanism of disease.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8582975PMC
http://dx.doi.org/10.1097/WNO.0000000000001454DOI Listing

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