Nadir Bir Olgu: COVID-19 ile ilişkili Papilödem

Abstract

COVID-19 ile ilişkili nörolojik durumlar daha önce çocuklarda bildirilmiştir. Burada, intrakraniyal hipertansiyona sekonder papil ödem gelişen 11 yaşında bir COVID-19 vakası sunuyoruz. 11 yaşında (önceden sağlıklı) bir hasta grip benzeri semptomların (ateş, boğaz ağrısı, öksürük) ardından şiddetli baş ağrısı ve belirgin bulanık görme ile başvurdu. Hastanın nörolojik muayenesi normaldi. Oftalmolojik muayenede bilateral Grade 1 optik disk ödemi tespit edildi. COVID-19 nazal sürüntü PCR testi pozitifti ve nörogörüntüleme normaldi. Hastanın COVID-19’a sekonder intrakraniyal hipertansiyonu olduğu düşünüldü ve hastaya asetazolamid tedavisi uygulandı. Takipte herhangi bir komplikasyon gelişmedi. COVID-19 enfeksiyonu birçok farklı klinikte ortaya çıkabilir. Burada, baş ağrısı ve bulanık görme ile başvuran bir hastada COVID-19 enfeksiyonunun nadir bir nörolojik belirtisi olan papil ödemi gösteriyoruz. Baş ağrısı (pozisyonla artan) ve görme bulanıklığı olan olgularda, olası intrakraniyal basınç artışının tanısı ve sekonder komplikasyonların (görme kaybı gibi) önlenmesi açısından ayrıntılı göz ve nörolojik muayene çok önemlidir.

Keywords

• Baş ağrısı
• COVID-19
• Nörolojik
• Papilödem

A Rare Case: COVID-19 Associated with Papilledema in Young Patient

Abstract

Neurological conditions related to COVID-19 have been previously reported in children. Here, we present an 11-year-old COVID-19 case who developed papilledema secondary to intracranial hypertension.An 11-year-old (previously healthy) patient presented with flu-like symptoms (fever, sore throat, cough) followed by severe headache and markedly blurred vision. The patient’s neurological examination was normal. Ophthalmological examination revealed bilateral Grade 1 optic disc edema. The nasal swab PCR of COVID-19 was positive, and neuroimaging was normal. The patient was considered to have intracranial hypertension secondary to COVID-19 and the patient was treated with acetazolamide. No complications developed in the follow-up. COVID-19 infection can present with many different clinics. Here, we show papilledema, a rare neurological manifestation of COVID-19 infection, in a patient presenting with headache and blurred vision. In cases with headache (increasing with positioning) and blurred vision, detailed ocular and neurological examinations are very important in terms of diagnosing possible increased intracranial pressure and preventing secondary complications (such as vision loss)

Keywords

• COVID-19
• Headache
• Neurological
• Papilledema

References

1. Aljomah, L., Almedlej, S., Baarmah, D., Altwaijri, W., Alrumayyan, A., Alrifai, M. T., Almuqbil, M., & Alshalaan, M. (2021). Pediatrics COVID-19 and neurological manifestations: Single tertiary centre experience. eNeurologicalSci, 24, 100355. https://doi.org/10.1016/j.ensci.2021.100355
2. Brun, B. N, & Aylward, S.C. (2021). Pediatric intracranial hypertension: A spotlight on imaging, the idiopathic intracranial hypertension treatment trial, and COVID-19 associated cases. In Seminars in Pediatric Neurology, 40, 12-01.
3. Chung, J.E, Lee, A.R, Guerriero, R.M, Reynolds, M.M. (2022). Papilledema associated with COVID-19 multisystem inflammatory syndrome in children. Can J Ophthalmol. 57(3), e94-e96.
4. Friedman, D.I, Liu, G.T, Digre, K.B. (2013). Revised diagnostic criteria for the pseudotumor cerebri syndrome in adults and children. Neurology. 24, 81(13), 1159-65.
5. Gaier, E.D, Heidary, G. (2019). Pediatric Idiopathic Intracranial Hypertension. Semin Neurol. 39(6), 704-710.
6. Lam, K., Lee, J.H, Chengi P., Ajani, Z., Salem, M.M, Sangha, N. (2021). Pediatric stroke associated with a sedentary lifestyle during the SARS-CoV-2 (COVID-19) pandemic: a case report on a 17-yearold. Neurol Sci. 42(1), 21-23.
7. Magboul, S., Khalil, A., Hassan, M., Habra, B., Alshami, A., Khan, S., Ellithy, K., Ali, H., AlHothi, A., AlMaslamani, E., AlAmri, M., De Sanctis, V., & Soliman, A. T. (2022). Multisystem inflammatory syndrome in children (MIS-C) related to COVID-19 infection in the state of Qatar: Association with Kawasaki-like Illness. Acta bio-medica : Atenei Parmensis, 92(6), e2021543. https://doi.org/10.23750/abm.v92i6.11991
8. Masri, A., Jaafar, A., Noman, R., Gharaibeh, A., Ababneh, O. H. Intracranial Hypertension in Children: Etiologies, Clinical Features, and Outcome. Journal of Child Neurology. 2015;30(12):1562-1568. doi:10.1177/0883073815574332

9. Rostamian, M., Afsharian, M., Akya, A., Chegene Lorestani, R., Habibi, R., Safaei, J. A, Sedighi, M., Ghadiri, K. (2022). Four Cases of Papilledema in COVID-19 Multisystem Inflammatory Syndrome in Children. Indian J Pediatr. 89(9), 921.
10. Tadevosyan, A., Kornbluth, J. (2021). Brain Herniation and Intracranial Hypertension. Neurol Clin. 39(2), 93-318.
11. Thaller, M., Tsermoulas , G., Sun, R., Mollan, S. P, Sinclair, A. J. (2021). Negative impact of COVID-19 lockdown on papilloedema and idiopathic intracranial hypertension. J Neurol Neurosurg Psychiatry. 92(7), 795-797
12. Tisdale, A. K, Dinkin, M., Chwalisz, B. K. (2021). Afferent and Efferent Neuro-Ophthalmic Complications of Coronavirus Disease 19. J Neuroophthalmol. 1, 41(2), 154-165.