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Lee S, Baek HJ. Pontocerebellar venous infarction caused by COVID-19 in a 13-year-old girl with underlying asymptomatic developmental venous anomaly. NEUROIMMUNOLOGY REPORTS 2022; 2. [PMCID: PMC9547657 DOI: 10.1016/j.nerep.2022.100148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Introduction COVID-19-associated coagulopathy (CAC) presents as a highly activated thrombotic status, leading to severe clinical outcomes. We report a unique pediatric case of pontocerebellar venous infarction caused by COVID-19 (omicron mutation) and accompanied by abnormal brain venous structure. Case A 13-year-old unvaccinated girl with high-grade fever and altered mental status visited our emergency department. In her initial serologic results, all the inflammatory markers were elevated; interleukin-6 was remarkably elevated (above 5000 pg/mL). On brain CT, a suspicious subtle hypo-attenuated lesion in the right interior cerebellar hemisphere area was observed; brain MRI revealed bilateral asymmetric hyperintense lesions in the mid-pons, and extensive cerebellar hemorrhage and engorged venous structure. Despite intensive medications and treatments, the patient failed to maintain her vital signs with a mechanical ventilator because of aggravated pneumonia and bilateral pleural effusion, and she died ten days after her hospital admission. Conclusion In our patient, a rapid systemic cytokine storm reaction occurred, and presumably, the resulting inflammation sequentially caused the coagulopathy cascade. One of the significant risk factors was an asymptomatic developmental venous anomaly (DVA) of the cerebellum. The asymptomatic DVA concomitant with COVID-19 may be associated with thrombosis and needs further brain imaging studies.
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Affiliation(s)
- Sunho Lee
- Department of Pediatrics, Gyeongsang National University Changwon Hospital, 11, Samjeongja-ro, Seongsan-gu, Changwon-si, Gyeongsangnam-do 51472, Republic of Korea,Corresponding author
| | - Hye Jin Baek
- Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
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Yu T, Liu X, Lin X, Bai C, Zhao J, Zhang J, Zhang L, Wu Z, Wang S, Zhao Y, Meng G. The relation between angioarchitectural factors of developmental venous anomaly and concomitant sporadic cavernous malformation. BMC Neurol 2016; 16:183. [PMID: 27660100 PMCID: PMC5034432 DOI: 10.1186/s12883-016-0691-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2016] [Accepted: 08/29/2016] [Indexed: 11/17/2022] Open
Abstract
Background Past studies found that cerebral developmental venous anomaly (DVA) is often concurrent with cavernous malformation (CM). But the reason of the concurrency remains unknown. The purpose of this study was to confirm whether angioarchitectural factors relate to the concurrence and which angioarchitectural factors can induce the concurrency. Methods DVA cases were selected from the records of the same 3.0 T MR. The DVA cases was divided into two group which are DVA group and DVA concurrent with CM group. 8 angioarchitectural factors of the DVAs were selected and measured. Statistical analysis was performed by the Pearson chi-square statistic,analysis of variance (ANOVA) and multi-factor logistic regression analysis. Results Five hundred three DVA lesions were found and 76 CM lesions coexisting with DVA. In the single factor analysis, all the 8 angioarchitectural factors of DVA were related to the concurrency. In the multivariate analysis, 6 angioarchitectural factors. Result of multi-factor logistic regression analysis is Logit(P) = -4.858-0.932(Location) + 1.616(Direction) + 1.757(Torsion) + 0.237(Number) + 2.119(Stenosis rate of medullary vein)-0.015(Angle), goodness of fit is 90.1 %. Conclusions The angioarchitectural factors of DVA are related to the concurrency of DVA and CM. 6 angioarchitectural factors may induce the concurrency.
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Affiliation(s)
- Tengfei Yu
- Department of Neurosurgery, Beijing Tiantan Hospital,Capital Medical University, China National Clinical Research Center for Neurological Diseases, Center of Stroke, Beijing Institute for Brain Disorders, Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, 6 Tiantan Xili, Chongwen District, Beijing, 100050, People's Republic of China
| | - Xing Liu
- Department of Neurosurgery, Beijing Tiantan Hospital,Capital Medical University, China National Clinical Research Center for Neurological Diseases, Center of Stroke, Beijing Institute for Brain Disorders, Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, 6 Tiantan Xili, Chongwen District, Beijing, 100050, People's Republic of China
| | - Xiangjiang Lin
- Department of Neurosurgery, Beijing Tiantan Hospital,Capital Medical University, China National Clinical Research Center for Neurological Diseases, Center of Stroke, Beijing Institute for Brain Disorders, Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, 6 Tiantan Xili, Chongwen District, Beijing, 100050, People's Republic of China
| | - Chuanfeng Bai
- Department of Neurosurgery, Beijing Tiantan Hospital,Capital Medical University, China National Clinical Research Center for Neurological Diseases, Center of Stroke, Beijing Institute for Brain Disorders, Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, 6 Tiantan Xili, Chongwen District, Beijing, 100050, People's Republic of China
| | - Jizong Zhao
- Department of Neurosurgery, Beijing Tiantan Hospital,Capital Medical University, China National Clinical Research Center for Neurological Diseases, Center of Stroke, Beijing Institute for Brain Disorders, Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, 6 Tiantan Xili, Chongwen District, Beijing, 100050, People's Republic of China
| | - Junting Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital,Capital Medical University, China National Clinical Research Center for Neurological Diseases, Center of Stroke, Beijing Institute for Brain Disorders, Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, 6 Tiantan Xili, Chongwen District, Beijing, 100050, People's Republic of China
| | - Liwei Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital,Capital Medical University, China National Clinical Research Center for Neurological Diseases, Center of Stroke, Beijing Institute for Brain Disorders, Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, 6 Tiantan Xili, Chongwen District, Beijing, 100050, People's Republic of China
| | - Zhen Wu
- Department of Neurosurgery, Beijing Tiantan Hospital,Capital Medical University, China National Clinical Research Center for Neurological Diseases, Center of Stroke, Beijing Institute for Brain Disorders, Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, 6 Tiantan Xili, Chongwen District, Beijing, 100050, People's Republic of China
| | - Shuo Wang
- Department of Neurosurgery, Beijing Tiantan Hospital,Capital Medical University, China National Clinical Research Center for Neurological Diseases, Center of Stroke, Beijing Institute for Brain Disorders, Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, 6 Tiantan Xili, Chongwen District, Beijing, 100050, People's Republic of China
| | - Yuanli Zhao
- Department of Neurosurgery, Beijing Tiantan Hospital,Capital Medical University, China National Clinical Research Center for Neurological Diseases, Center of Stroke, Beijing Institute for Brain Disorders, Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, 6 Tiantan Xili, Chongwen District, Beijing, 100050, People's Republic of China
| | - Guolu Meng
- Department of Neurosurgery, Beijing Tiantan Hospital,Capital Medical University, China National Clinical Research Center for Neurological Diseases, Center of Stroke, Beijing Institute for Brain Disorders, Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, 6 Tiantan Xili, Chongwen District, Beijing, 100050, People's Republic of China.
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