Journal Article Ppublish 2 citations
PubMed: 36990723 DOI: 10.1212/WNL.0000000000207213
Pearls & Oy-sters: Hemorrhagic Myelitis Following SARS-CoV-2 Infection.
Neurology 101(6):e672-e676
Authors: Karlo Toljan, Ahmad Mahadeen, Moein Amin, Mary Rensel, Stephen E Jones, Daniel Ontaneda, Amy C Kunchok
Affiliations
- From the Department of Neurology (K.T. M.A.), and Mellen Center for Multiple Sclerosis Treatment and Research (A.M. M.R. D.O. A.C.K.), Neurological Institute, and Section of Neuroradiology (S.E.J.), Imaging Institute, Cleveland Clinic, OH.
- From the Department of Neurology (K.T. M.A.), and Mellen Center for Multiple Sclerosis Treatment and Research (A.M. M.R. D.O. A.C.K.), Neurological Institute, and Section of Neuroradiology (S.E.J.), Imaging Institute, Cleveland Clinic, OH.
Abstract
Hemorrhage in the setting of myelitis is rarely seen in clinical practice. We report a series of 3 women aged 26, 43, and 44 years, who presented with acute hemorrhagic myelitis within 4 weeks of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Two required intensive care, and 1 had severe disease with multiorgan failure. Serial MRI of the spine demonstrated T2-weighted hyperintensity with T1-weighted postcontrast enhancement in the medulla and cervical spine (patient 1) and thoracic spine (patients 2 and 3). Hemorrhage was identified on precontrast T1-weighted, susceptibility-weighted, and gradient echo sequences. Distinct from typical inflammatory or demyelinating myelitis, clinical recovery was poor in all cases, with residual quadriplegia or paraplegia, despite immunosuppression. These cases highlight that although hemorrhagic myelitis is rare, it can occur as a post/parainfectious complication of SARS-CoV-2 infection.
MeSH
Sars-Cov-2, Myelitis, Covid-19, Severe Acute Respiratory Syndrome-Related Coronavirus, Neurology, Infections, Spine