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The authors present 5 cases that illustrate varying imaging presentations of acute encephalopathy in patients with coronavirus disease 2019. MR features include leukoencephalopathy, diffusion restriction that involves the GM and WM, microhemorrhages, and leptomeningitis.

This was a retrospective study performed at a large academic hospital in the United States. A total of 641 patients presented to the authors' institution between March 3, 2020 and May 6, 2020, for treatment of coronavirus disease 2019, of whom, 150 underwent CT and/or MR imaging of the brain. CT and/or MR imaging examinations were evaluated for the presence of hemorrhage, infarction, and leukoencephalopathy. Of the 150 patients, 26 (17%) had abnormal CT and/or MR imaging findings, with hemorrhage in 11 of the patients (42%), infarction in 13 of the patients (50%), and leukoencephalopathy in 7 of the patients (27%). Significant associations were seen between abnormal CT/MR imaging findings and intensive care unit admission, intubation, and acute kidney injury.

The authors retrospectively reviewed tentorial venous anatomy of the head using CTA/CTV performed for routine care or research purposes in 238 patients. Tentorial vein development was related to the ring configuration of the tentorial sinuses. There were 3 configurations: Groups 1A and 1B had ring configuration, while group 2 did not. Group 1A had a medialized ring configuration, and group 1B had a lateralized ring configuration. Measurements of skull base development were predictive of these groups. The ring configuration of group 1 was related to the presence of a split confluens, which correlated with a decreased internal auditory canal-petroclival fissure angle. Configuration 1A was related to the degree of petrous apex pneumatization.