Possible affective cognitive cerebellar syndrome in a young patient with COVID-19 CNS vasculopathy and stroke.
Possible affective cognitive cerebellar syndrome in a young patient with COVID-19 CNS vasculopathy and stroke.
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DOI：
10.1136/bcr-2020-237926
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发表时间：
2020-10-15
期刊：
影响因子：
0.9
通讯作者：
Bruno SD
中科院分区：
文献类型：
--
作者：
Chia KX;Polakhare S;Bruno SD
早期病例系列表明，在2%-6%的住院患者中，约三分之一的COVID-19患者出现神经系统症状，包括脑血管疾病。这些通常是有严重感染和合并症的老年患者。在这里，我们讨论一个病例，以前健康和良好的39岁男子谁提出发烧和呼吸道症状，发展为肺炎伴缺氧，但只需要持续气道正压。呼吸系统疾病消退后，患者出现局灶性神经病学，并发现双侧枕部、丘脑和小脑梗死。诊断为COVID-19中枢神经系统血管病变。他出现了严重的神经精神综合症，包括偏执、易怒、攻击性和去抑制，需要抗精神病药物治疗并转移到神经康复中心。神经心理测量显示了广泛的认知缺陷。疾病的快速演变与神经精神病学图像的快速解决相匹配，伴有轻度残余认知障碍。
Early case series suggest that about one-third of patients with COVID-19 present with neurological manifestations, including cerebrovascular disease, reported in 2%–6% of hospitalised patients. These are generally older patients with severe infection and comorbidities. Here we discuss the case of a previously fit and well 39-year-old man who presented with fever and respiratory symptoms, evolving in pneumonia with hypoxia but only requiring continuous positive airway pressure. After resolution of the respiratory disease, the patient developed focal neurology and was found to have bilateral occipital, thalamic and cerebellar infarcts. A diagnosis of COVID-19 central nervous system vasculopathy was made. He developed a florid neuropsychiatric syndrome, including paranoia, irritability, aggression and disinhibition, requiring treatment with antipsychotics and transfer to neurorehabilitation. Neuropsychometry revealed a wide range of cognitive deficits. The rapid evolution of the illness was matched by fast resolution of the neuropsychiatric picture with mild residual cognitive impairment.