Brain microvascular occlusive disorder in COVID-19: a case report

Laura Saitta, Alexandre Molin, Flavio Villani, Angelo Insorsi, Luca Roccatagliata, Matilde Inglese, Matteo Bassetti, Paolo Pelosi, Lucio Castellan, Simonetta Gerevini, Chiara Robba, Nicolò Patroniti

Research output: Contribution to journalArticlepeer-review


We describe the case of a COVID-19 patient with severely impaired consciousness after sedation hold, showing magnetic resonance imaging (MRI) findings of (i) acute bilateral supratentorial ischemic lesions involving the fronto-parietal white matter and the corpus callosum and (ii) multiple diffuse susceptibility weighted imaging (SWI) hypointense foci, infra and supratentorial, predominantly bithalamic, suggestive of microhemorrhage or alternatively microthrombi. Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) RNA was detected in the cerebrospinal fluid. Our findings suggest the occurrence of vascular damage, predominantly involving microvessels. The underlying mechanisms, which include direct and indirect penetration of the virus to the central nervous system and systemic cardiorespiratory complications, are yet to be elucidated, and a direct correlation with SARS-CoV-2 infection remains uncertain.

Original languageEnglish
JournalNeurological Sciences
Publication statusAccepted/In press - 2020


  • Coagulopathy
  • Covid-19
  • Inflammation
  • Ischemia
  • Microthrombi
  • Neurological complications

ASJC Scopus subject areas

  • Dermatology
  • Clinical Neurology
  • Psychiatry and Mental health


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