脱髓鞘病1例脑静脉血栓与covid-19临床表现

Ye. G. Klocheva, F. Z. Olimova, V. Goldobin, J. D. Bogatenkova
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摘要

实际上,验证与COVID-19相关的神经系统疾病会让临床医生提出几个问题:神经系统病理的表现是由COVID-19引起的,还是多种中枢神经系统病理与COVID-19合并。我们报告一例57岁女性中枢神经系统脱髓鞘病、脑静脉血栓合并临床转移性COVID-19的临床病例。鉴别诊断为多发性硬化症、急性多发性脑脊髓炎、视神经脊髓炎、大脑常染色体显性动脉病变伴皮质下梗死和脑白质病、结节病、抗磷脂综合征、线粒体脑病伴乳酸酸中毒和脑卒中样发作(MELAS)和大半球静脉血栓形成。强调脱髓鞘发展的可能致病变异及其与脑静脉血栓形成和COVID-19的可能联系。
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Demyelinating disease in a patient with cerebral venous thrombosis and covid-19 clinical manifestations
Actually, verifying neurological disorders associated with COVID-19 make clinicians ask several questions: the manifestation of neurological pathology is due to COVID-19, or there is a combination of several CNS pathologies with COVID-19. We report a clinical case of a 57-year-old female patient with demyelinating disease of the central nervous system, cerebral venous thrombosis associated with clinically transferred COVID-19. Differential diagnosis was performed with multiple sclerosis, acute multiple encephalomyelitis, opticomyelitis, cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy, sarcoidosis, antiphospholipid syndrome, mitochondrial encephalopathy with lactic acidosis and stroke-like episodes (MELAS) and thrombosis veins of the large hemispheres. Probable pathogenetic variants of demyelination development and possible connection with cerebral venous thrombosis and COVID-19 are highlighted.
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