• Theodoros Ladopoulos, Ramin Zand, Shima Shahjouei, Jason J Chang, Jeremias Motte, Jeyanthan Charles James, Aristeidis H Katsanos, Ali Kerro, Ghasem Farahmand, Alaleh Vaghefi Far, Nasrin Rahimian, Seyed Amir Ebrahimzadeh, Vida Abedi, Matilda Papathanasiou, Adnan Labedi, Ruth Schneider, Carsten Lukas, Sotirios Tsiodras, Georgios Tsivgoulis, and Christos Krogias.
• Department of Neurology, St. Josef-Hospital Bochum, Ruhr University Bochum, Bochum, Germany.
• J Neuroimaging. 2021 Mar 1; 31 (2): 228243228-243.

Background And PurposeThe ongoing Coronavirus Disease 2019 (COVID-19) pandemic is caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). COVID-19 is occasionally associated with manifold diseases of the central nervous system (CNS). We sought to present the neuroimaging features of such CNS involvement. In addition, we sought to identify typical neuroimaging patterns that could indicate possible COVID-19-associated neurological manifestations.MethodsIn this systematic literature review, typical neuroimaging features of cerebrovascular diseases and inflammatory processes associated with COVID-19 were analyzed. Reports presenting individual patient data were included in further quantitative analysis with descriptive statistics.ResultsWe identified 115 studies reporting a total of 954 COVID-19 patients with associated neurological manifestations and neuroimaging alterations. A total of 95 (82.6%) of the identified studies were single case reports or case series, whereas 660 (69.2%) of the reported cases included individual information and were thus included in descriptive statistical analysis. Ischemia with neuroimaging patterns of large vessel occlusion event was revealed in 59.9% of ischemic stroke patients, whereas 69.2% of patients with intracerebral hemorrhage exhibited bleeding in a location that was not associated with hypertension. Callosal and/or juxtacortical location was identified in 58.7% of cerebral microbleed positive images. Features of hemorrhagic necrotizing encephalitis were detected in 28.8% of patients with meningo-/encephalitis.ConclusionsManifold CNS involvement is increasingly reported in COVID-19 patients. Typical and atypical neuroimaging features have been observed in some disease entities, so that familiarity with these imaging patterns appears reasonable and may assist clinicians in the differential diagnosis of COVID-19 CNS manifestations.© 2021 The Authors. Journal of Neuroimaging published by Wiley Periodicals LLC on behalf of American Society of Neuroimaging.

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