Title:Concurrent Diffuse Dural and Leptomeningeal Enhancements in Brain
Magnetic Resonance Imaging Following a Mild COVID-19 Infection: A Novel
Case Report and Review of Literature
Volume: 20
Author(s): Rashed Bawand, Masoud Ghiasian*Mustapha Samadyan
Affiliation:
- Department of Neuroimmunology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
Keywords:
COVID-19, Dural enhancement, Leptomeningeal involvement, Headache, Case report, Neuroimaging.
Abstract:
Introduction:
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.
Case Report:
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.
Conclusion:
Inflammatory complications of the central nervous system caused by COVID-19 can occur in different forms and types, and clinicians should
consider them.