COVID-19-associated meningoencephalitis complicated with intracranial hemorrhage: a case report

Acta Neurochir (Wien). 2020 Jul;162(7):1495-1499. doi: 10.1007/s00701-020-04402-w. Epub 2020 May 20.

Abstract

The coronavirus pandemic that started in December 2019 is mainly related to clinical pictures consistent with respiratory symptoms; nevertheless, reports about neurological complications have recently appeared in the medical literature. We describe a case of a 36-year-old coronavirus-positive patient that was admitted on emergency basis; his clinical presentation included neurological symptoms such as drowsiness and mild confusion. Imaging revealed findings consistent with meningoencephalitis complicated by intracerebral hematoma and subdural hematoma. The latter was surgically evacuated after it became chronic and evidence of coronavirus was found in the fluid. Our experience confirms that neurological complications might be a likely event in COVID-19. Although uncommon, the possible occurrence of meningoencephalitis should be kept in mind by physicians involved in the management of COVID-19 patients. Early recognition of brain involvement may provide better prognosis, preventing evolution into intracerebral hemorrhagic events.

Keywords: COVID-19; Encephalitis; ICH; Meningoencephalitis; SDH.