Abstract
Increasing numbers of the papers indicate that SARS-CoV-2 also causes neurological symptoms; the underlying mechanism has not been elucidated yet. Hypothetic mechanisms to explain the CNS involvement of SARS-CoV-2 include the neurotropic mechanisms and the cytokine storm developing during the disease process. A middle age female patient applied to the emergency department with complaints of eye pain, a double, foggy, and blurred vision and a severe throbbing headache. The outward gaze was found to be limited in her right eye. Nasopharyngeal swab for SARS-CoV-2 RNA was positive, radiological findings were supported the COVID pneumonia and diffuse sinonasal inflammation. Cranial imaging showed thickening and contrast involvement in the cavernous sinus in the postcontrast series. While shortness of breath improved, and the headache was completely resolved on the 10th day of treatment the right eye outward gaze restriction was continued. The control MRI reveals a significant reduction in cavernous thickening and contrast enhancement and complete resolution in dural thickening. In our case of COVID, cranial nerve involvement and pansinusitis developed without cytokine storm findings suggests that the virus has spread to the cavernous sinuses and dura by regional neighborhood. Neurological symptoms may appear as the first symptom of COVID.
Keywords
Thanks
Our dear colleague, who we lost during the fight against COVID-19, Dr. Yavuz DURMUŞ contributed to the diagnosis of the case. We remember him with gratitude.
References
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- 2. Li Z, Liu T, Yang N, Han D, Mi X, Li Y, et al. Neurological manifestations of patients with COVID-19: potential routes of SARS-CoV-2 neuroinvasion from the periphery to the brain. Front Med 2020;14;533-41.
- 3. Zubair AS, McAlpine LS, Gardin T, Farhadian S, Kuruvilla DE, Spudich S. Neuropathogenesis and neurologic manifestations of the coronaviruses in the age of coronavirus disease 2019: a review. JAMA Neurol 2020;77:1018-27.
- 4. Dinkin M, Gao V, Kahan J, Bobker S, Simonetto M, Wechsler P, et al. COVID-19 presenting with ophthalmoparesis from cranial nerve palsy. Neurology 2020;95:221-3.
- 5. Gutiérrez-Ortiz C, Méndez A, Rodrigo-Rey S, San Pedro-Murillo E, Bermejo-Guerrero L, Gordo-Mañas R, et al. Miller Fisher Syndrome and polyneuritis cranialis in COVID-19. Neurology 2020;95:e601-5.
Abstract
References
- 1. Vonck K, Garrez I, De Herdt V, Hemelsoet D, Laureys G, Raedt R, et al. Neurological manifestations and neuro-invasive mechanisms of the severe acute respiratory syndrome coronavirus type 2. Eur J Neurol 2020;27;1578-87.
- 2. Li Z, Liu T, Yang N, Han D, Mi X, Li Y, et al. Neurological manifestations of patients with COVID-19: potential routes of SARS-CoV-2 neuroinvasion from the periphery to the brain. Front Med 2020;14;533-41.
- 3. Zubair AS, McAlpine LS, Gardin T, Farhadian S, Kuruvilla DE, Spudich S. Neuropathogenesis and neurologic manifestations of the coronaviruses in the age of coronavirus disease 2019: a review. JAMA Neurol 2020;77:1018-27.
- 4. Dinkin M, Gao V, Kahan J, Bobker S, Simonetto M, Wechsler P, et al. COVID-19 presenting with ophthalmoparesis from cranial nerve palsy. Neurology 2020;95:221-3.
- 5. Gutiérrez-Ortiz C, Méndez A, Rodrigo-Rey S, San Pedro-Murillo E, Bermejo-Guerrero L, Gordo-Mañas R, et al. Miller Fisher Syndrome and polyneuritis cranialis in COVID-19. Neurology 2020;95:e601-5.
Details
| Primary Language | English |
|---|---|
| Subjects | Neurosciences |
| Journal Section | Case Reports |
| Authors | |
| Publication Date | January 4, 2022 |
| Submission Date | July 3, 2021 |
| Acceptance Date | October 7, 2021 |
| Published in Issue | Year 2022 Volume: 8 Issue: 1 |
