Rıdvan AÇIKALIN, Murat GOKTEN, Can SEZER

COVID-19'un santral sinir sistemi tutulumunu değerlendirmek için bir araç olarak manyetik rezonans görüntülemenin etkinliği

Amaç: Çalışmamızın amacı, COVID-19 ile ilişkili akut nörolojik bulguları olan hastaları tanımlamayı ve tanısında manyetik rezonans görüntüleme (MRG) etkinliğinin gösterilmesini amaçlamaktır. Gereç ve Yöntem: Haziran 2020 ve Aralık 2021 tarihleri arasında kliniğimizde Covid-19 tanısı almış, akciğerde pnömoni bulguları olan, akut nörolojik bulguları olan ve Beyin MRG olan 90 hasta çalışmaya alındı. Bulgular santral sinir sistemi (SSS) tutulumu bulgulari olmayan 46 hasta ve SSS bulgulari olan 44 hasta retrospektif olarak değerlendirildi. Bulgular: COVID-19 hastalarında en sık görülen nörolojik belirtiler; tedavi ile açıklanamayan şuur kayıbı (28/44, %63,6), focal nörolojik defisit (21/44, %47,7) and nöbet (9/44, %20,4). SSS tutulumu olan hastalarda yoğunbakımda yatış sürelerinde uzama, ventilator desteği gereksinimde artış ve mortalitede artış görüldü. Nörolojik semptomları olan 44 hastaya beyin MRG çekildi. MRG çekilen hastalarda 68,3 ortalama yaş (45–78). 32 hastanın (%72) MRG’nda akut bulgular saptandı. Beyin MR görüntülemesinde en sık konulan tanılar akut ve subakut infarktlardı. Sonuç: Merkezi sinir sistemi bulgularının mekanizması hala belirsizdir, COVID-19 hastalarında nörolojik semptomlar özellikle yoğun bakım ünitelerinde önemli bir sorundur. Bu nedenle SSS tutulumunun erken tespiti ve tedavisi çok önemlidir.

Anahtar Kelimeler:

Covid-19, konfüzyon, santral sinir sistemi, MRI.

Efficacy of magnetic resonance imaging as a tool to assess central nervous system involvement of COVID-19

Purpose: The aim of this study was to identify patients with acute neurological findings associated with COVID-19 and to demonstrate the effectiveness of magnetic resonance imaging (MRI) in its diagnosis. Materials and Methods: Between June 2020 and December 2021, 90 patients who were diagnosed with Covid-19 in our clinic, had pneumonia findings in the lung, acute neurological findings, and brain MRI were included in the study. Results were evaluated retrospectively for 46 patients without central nervous system (CNS) involvement and 44 patients with CNS findings. Results: The most common neurological symptoms in COVID-19 patients; Unexplained loss of consciousness by treatment (28/44, 63.6%), focal neurologic deficits (21/44, 47.7%), and seizures (9/44, 20.4%). Increased mortality, increment in the need for ventilator support, and prolonged stay in the intensive care unit were observed in patients with CNS findings. Brain MRI was performed on 44 patients with neurological symptoms. Mean age of 68.3 years (45–78) in patients undergoing MRI. Acute findings were detected in MRI of 32 patients (72%). The most common diagnoses in brain MRI were acute and subacute infarcts. Conclusion: The mechanism of CNS manifestations is still unclear, and neurological symptoms in COVID-19 patients are an important problem, especially in intensive care units. Therefore, early detection and treatment of CNS involvement are very important.

Keywords:

Covid-19, confusion, central nervous system, MRI.,

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