tetano
Editor, Senior Moderator
Rev Esp Anestesiol Reanim (Engl Ed)
. 2023 Jan 5;S2341-1929(23)00002-1.
doi: 10.1016/j.redare.2023.01.001. Online ahead of print.
Posterior reversible encephalopathy syndrome in critical COVID-19 patients: Report of 2 cases
J J Tortajada Soler 1 , M P Tauler Redondo 2 , M Garví López 2 , M B Lozano Serrano 2 , J López-Torres López 2 , M L Sánchez López 2
Affiliations
PMID: 36621570 DOI: 10.1016/j.redare.2023.01.001
Abstract
Posterior reversible encephalopathy syndrome is an acute neurological disorder characterized by variable symptoms and radiological images characteristic of vasogenic parietal-occipital edema. It is associated with clinical conditions such as high blood pressure, infection/sepsis, or cytotoxic/immunosuppressive drugs, among others. It is characterized pathophysiologically by endothelial damage with breakdown of blood-brain barrier, cerebral hypoperfusion, and vasogenic edema. The cases are presented on 2 critical COVID-19 patients who were admitted to pneumonia requiring mechanical ventilation and who, after removing sedation, developed acute and reversible neurological symptoms consisting of epilepsy and encephalopathy, associated with hyperintense subcortical lesions on brain magnetic resonance imaging compatible with posterior reversible encephalopathy syndrome. SARS-CoV-2 coronavirus would activate an inflammatory response that would damage brain endothelium. It could be triggered by cytokine release, as well as by direct viral injury, given that endothelium expresses ACE2 receptors. It could explain the possible association between posterior reversible encephalopathy syndrome and COVID-19.
Keywords: COVID-19; Disfunción endotelial; Encefalopatía; Encephalopathy; Endothelial dysfunction; Epilepsia; Epilepsy; Posterior reversible encephalopathy syndrome; Síndrome de encefalopatía posterior reversible.
. 2023 Jan 5;S2341-1929(23)00002-1.
doi: 10.1016/j.redare.2023.01.001. Online ahead of print.
Posterior reversible encephalopathy syndrome in critical COVID-19 patients: Report of 2 cases
J J Tortajada Soler 1 , M P Tauler Redondo 2 , M Garví López 2 , M B Lozano Serrano 2 , J López-Torres López 2 , M L Sánchez López 2
Affiliations
PMID: 36621570 DOI: 10.1016/j.redare.2023.01.001
Abstract
Posterior reversible encephalopathy syndrome is an acute neurological disorder characterized by variable symptoms and radiological images characteristic of vasogenic parietal-occipital edema. It is associated with clinical conditions such as high blood pressure, infection/sepsis, or cytotoxic/immunosuppressive drugs, among others. It is characterized pathophysiologically by endothelial damage with breakdown of blood-brain barrier, cerebral hypoperfusion, and vasogenic edema. The cases are presented on 2 critical COVID-19 patients who were admitted to pneumonia requiring mechanical ventilation and who, after removing sedation, developed acute and reversible neurological symptoms consisting of epilepsy and encephalopathy, associated with hyperintense subcortical lesions on brain magnetic resonance imaging compatible with posterior reversible encephalopathy syndrome. SARS-CoV-2 coronavirus would activate an inflammatory response that would damage brain endothelium. It could be triggered by cytokine release, as well as by direct viral injury, given that endothelium expresses ACE2 receptors. It could explain the possible association between posterior reversible encephalopathy syndrome and COVID-19.
Keywords: COVID-19; Disfunción endotelial; Encefalopatía; Encephalopathy; Endothelial dysfunction; Epilepsia; Epilepsy; Posterior reversible encephalopathy syndrome; Síndrome de encefalopatía posterior reversible.