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5 results

  • “Delirium and COVID-19”: From Symptomatology to Laboratorial and Neuroimaging Findings”

  • D. Telles Correia, F. Novais
  • Journal:
    European Psychiatry / Volume 65 / Issue S1 / June 2022
    Published online by Cambridge University Press:
    01 September 2022, p. S28
    • Article
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  • Introduction

    The infection caused by the SARS-CoV-2 virus called COVID-19 may affect not only the respiratory system but also the central nervous system (CNS). Delirium is a frequent and serious condition in COVID-19 patients and may be caused by the direct invasion of the CNS or the induction of CNS inflammatory mediators or by indirect effects due to the systemic inflammatory status, other organ failure, prolonged mechanical ventilation time, immobilization but also social isolation. We aim to critically review literature reporting this syndrome in patients infected by the SARS-CoV-2 virus with a particular emphasis on reported clinical, laboratorial and neuroimaging findings. Methods: A state-of-the-art literature review was performed using PubMed, Embase and Web of Knowledge using the following keywords: delirium, COVID-19, SARS-Cov-2, neuroimaging, laboratorial findings. Results: More than 50% of patients with COVID-19 may present with delirium and in about 20% of the cases this is the primary presentation of the disorder. Previous data suggests that these patients may show a higher frequency of certain symptoms such as agitation, myoclonus, abulia, and alogia. Some distinct neuroinflammatory syndromes have been identified in patients presenting with delirium associated with the virus, namely, autoimmune encephalitis, Acute Disseminated Encephalomyelitis (ADEM) and stroke showing its potential for CNS involvement. Many of these patients present normal brain imaging, EEG and CSF findings but others have more specific laboratorial changes such as elevated creatinine kinase, elevated D-dimer levels, abnormal coagulation parameters and positive SARS-Cov-2 PCR in CSF or meningeal enhancement, ischemic stroke and perfusion changes in MRI imaging.

    Disclosure

    No significant relationships.

  • Chapter 20 - Cerebral microbleeds and thrombolysis

  • from Section 3 - Microbleeds in relation to specific populations, diseases and neurological symptoms
  • Edited by David J. Werring, Institute of Neurology, London
  • Book:
    Cerebral Microbleeds
    Published online:
    05 July 2011
    Print publication:
    26 May 2011, pp 173-177

  • Summary

    Cerebral amyloid angiopathy (CAA) occurs commonly in the elderly population. It results in thickening of the vessel wall, primarily in small arteries and arterioles of the leptomeninges and cerebral cortex. Primary intracerebral hemorrhage (ICH) in the elderly is the result of disease of the small cerebral vessels, in particular hypertensive vasculopathy or CAA. The CAA-related cerebral microbleeds (CMBs), like other types of microbleed, consist primarily of macrophages containing hemosiderin, a degraded form of ferritin. The most commonly employed criteria for diagnosis of CAA-related ICH are based on neuropathological examination or, more commonly, characteristic neuroimaging findings. Despite its high age-related prevalence, CAA has been difficult to detect non-invasively and is, likely to be underestimated in its effects on the aging process. The occurrence of CAA-related CMBs has emerged as the most useful diagnostic marker for CAA in clinical practice and investigation.

  • Chapter 19 - Cerebral microbleeds and antithrombotictreatment

  • from Section 3 - Microbleeds in relation to specific populations, diseases and neurological symptoms
  • Edited by David J. Werring, Institute of Neurology, London
  • Book:
    Cerebral Microbleeds
    Published online:
    05 July 2011
    Print publication:
    26 May 2011, pp 165-172

  • Summary

    This chapter reviews the pathophsyiology and pathology of hypertensive arteriopathy of the brain and its relationship to neuroimaging findings, particularly cerebral microbleeds (CMBs). The prevalence of hypertension is highly age dependent. Hypertension-related cerebral diseases include hypertensive encephalopathy, stroke and vascular cognitive impairment. Although the term arteriopathy includes both arteries and arterioles, the chapter focuses on the intrinsic vascular pathology of arterioles in hypertension. Intracranial atherosclerosis of large arteries is more common in hypertension. The presence of hypertensive arteriolosclerosis must be inferred indirectly. Hypertension is a common age-related disease that is accompanied by loss of vascular integrity, with leakage of red blood cells and perivascular hemosiderin deposition. Cerebral microbleeds caused by hypertensive arteriopathy may be seen in the deep hemispheric regions, brainstem, cerebellum and cerebral lobes; however, the pattern of purely lobar CMBs strongly suggests cerebral amyloid angiopathy (CAA) rather than hypertensive arteriopathy.

  • Chapter 15 - Cerebral microbleeds inCADASIL

  • from Section 3 - Microbleeds in relation to specific populations, diseases and neurological symptoms
  • Edited by David J. Werring, Institute of Neurology, London
  • Book:
    Cerebral Microbleeds
    Published online:
    05 July 2011
    Print publication:
    26 May 2011, pp 135-141

  • Summary

    Cerebral microbleeds (CMB) are considered a marker of an underlying hemorrhage-prone small vessel vasculopathy. The brain changes that accompany CMB may be a direct consequence of the CMB, of an underlying vasculopathy, or of risk factors associated with CMB or the underlying vasculopathies that cause CMB. This chapter reviews data associating CMBs with other neuroimaging findings. The relationships between CMBs and brain infarcts, hemorrhage and brain atrophy is discussed in general and in the context of specific small vessel diseases. CMBs are more frequent in patients with neuroimaging findings of white matter lesions (WML) and lacunar infarctions. By contrast, CMBs are not independently associated with brain atrophy, probably because the actual tissue damage directly caused by CMBs is minimal. These observations are consistent with the concept that CMBs are one of several neuroimaging markers of small vessel arterial disease.

  • 21 - Does disordered brain development occur across diagnostic boundaries?

  • Edited by Matcheri S. Keshavan, University of Pittsburgh, James L. Kennedy, Clarke Institute of Psychiatry, Toronto, Robin M. Murray, Institute of Psychiatry, London
  • Book:
    Neurodevelopment and Schizophrenia
    Published online:
    04 August 2010
    Print publication:
    18 November 2004, pp 390-412

  • Summary

    This chapter focuses on the neurodevelopmental basis of diagnostic overlap and symptom commonality by addressing similarities and differences in the neuroanatomical and functional neurochemical basis of three common childhood/adolescent-onset neuropsychiatric disorders: attention-deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), and mood disorder, including major depressive disorder (MDD) and bipolar disorder (BPD). These disorders are selected because of the clinical commonalities with schizophrenia and because of the known or presumed developmental origins of these disorders. Schizophrenia, BPD, and OCD have their onset in adolescence or early adulthood, and they may be preceded by symptoms similar to those in developmental disorders such as ADHD. The disorders are discussed in comparison with schizophrenia. The chapter describes the relevant findings in schizophrenia. It limits the pathophysiological discussion to the neuroimaging findings, and considers common genetic and environmental etiologic factors that may cut across these disorders.