Clinical cases of “MR-negative” myelopathy amid SARS-CoV-2 infection
Yana B. Kushnir,
Alexander I. Bezvodinskikh,
Anastasiya V. Vladykina,
Andrey A. Gotovchikov,
Natalya A. Totolyan https://doi.org/10.22328/2413-5747-2023-9-4-97-106
Abstract
INTRODUCTION. Neurological complications are often observed in patients with a new coronavirus infection. Cerebrovascular diseases prevail among them. There is damage to the peripheral nervous system and spinal cord of various kind, including inflammatory and vascular myelopathy. The incidence of myelopathy syndrome among all neurological complications of the new coronavirus infection reaches 3%.
OBJECTIVE. To characterize clinical and instrumental features of the rare case – “МR-negative” myelopathy amid SARS-CoV-2 infection.
MATERIALS AND METHODS. The article describes a clinical case of myelopathy, associated with COVID-19 without structural changes in the spinal cord on MR-imaging using standard pulse sequences, however, visualized via spinal tractography.
CONCLUSION. COVID-19 associated myelopathy is one of the characteristic complications amid the new coronavirus infection. To verify “MR-negative” damage to the central nervous system in COVID-19, advanced protocols of MRI studies might be used, including the promising method – МR-tractography.
About the Authors
Yana B. Kushnir
Pavlov First Saint Petersburg State Medical University
Russian Federation
Russian Federation
Neurologist, Department of Neurology №1
Alexander I. Bezvodinskikh
Pavlov First Saint Petersburg State Medical University
Russian Federation
Russian Federation
Clinical Resident of the Department of Neurology №1
Anastasiya V. Vladykina
Pavlov First Saint Petersburg State Medical University
Russian Federation
Russian Federation
Clinical Resident of the Department of Neurology № 1
Andrey A. Gotovchikov
Pavlov First Saint Petersburg State Medical University
Russian Federation
Russian Federation
MD neurologist, head of the Department of Neurology №1
Natalya A. Totolyan
Pavlov First Saint Petersburg State Medical University
Russian Federation
Russian Federation
Dr of Sci. (Med.), Professor, Department of Neurology
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Supplementary files
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1. Fig. 1. Contrast-enhanced MRI of the thoracic spinal cord, 3 Tesla. Sagittal projection in modes: A – T2-FLAIR; Б – T1 with contrast enhancement. Axial projection at Th-10 level in modes: В – T2-FLAIR; Г – T1 with contrast enhancement. The MR signal from the spinal cord is unchanged, the spinal cord structure is homogeneous. No pathological accumulation of contrast agent was detected. | |
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2. Fig. 2. Contrast-enhanced 1.5 Tesla MRI of the brain. Sagittal projection in modes: A – T2-FLAIR; Б – T1 with contrast enhancement. Axial projection in modes: В – T2-FLAIR; Г - T1 with contrast enhancement; Д – DWI; Е – ADC. There is an area of pathological MR signal in the valley of the corpus callosum with indistinct contours, characterized by a partially heterogeneous hyperintense MR signal on T2-FLAIR, weakly hypo- and isointense on T1 VI. The DWI with b=1000 shows a predominance of vasogenic edema with a linearly shaped area of cytotoxic edema. | |
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3. Fig. 3. Thoracic spinal cord tractography. A focus of decreased fractional anisotropy was detected in the right half of the spinal cord cone at the level of Th10 | |
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Review
For citations:
Kushnir Ya.B., Bezvodinskikh A.I., Vladykina A.V., Gotovchikov A.A., Totolyan N.A. Clinical cases of “MR-negative” myelopathy amid SARS-CoV-2 infection. Marine Medicine. 2023;9(4):97-106. https://doi.org/10.22328/2413-5747-2023-9-4-97-106
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