Severe headache as the first presentation of post-COVID-19 brain and spinal cord injury resembling neurosarcoidosis.

Abstract

Purpose: Sarcoidosis, a multi-organ granulomatous disease, occasionally involves the nervous system, presenting as neurosarcoidosis. The following case demonstrates a potential association between COVID-19 and brain and spinal cord injury mimicking neurosarcoidosis.

Case description: A 51-year-old woman presented with persistent holocranial headache, nausea, vertigo, and neurological deficits one month after a COVID-19 hospitalization. Neurological examination revealed hemiparesis, dysphagia, and ataxia. Imaging showed lesions in the central nervous system. A diagnosis of neurosarcoidosis was considered, supported by clinical criteria, imaging findings, and elevated ACE levels. Steroid therapy led to symptom improvement.

Comment: This case underscores the broad range of the consequences of COVID-19 and challenges in diagnosing neurosarcoidosis, suggesting the need for further research in this area.