Brain Imaging of Patients with COVID-19: Findings at an Academic Institution during the Height of the Outbreak in New York City

Corpus callosum microhemorrhages. A 65-year-old woman (A), a 44-year-old woman (B), and a 69-year-old man (C) all demonstrate microhemorrhages on SWI, with a similar distribution, preferentially involving the corpus callosum (arrows in A–C), particularly the splenium. All patients had undergone mechanical ventilation before imaging. The distribution is similar to that previously described in critically ill, ventilated patients as well as in those with high-altitude cerebral edema.

PRES. A 65-year-old woman (A, same patient as in Fig 2A) and 63-year-old man (B and C) demonstrate a typical imaging appearance of PRES on T2-FLAIR images (arrows in A and B), with bilateral subcortical occipital white matter hyperintense signal, as well as more pronounced involvement of the patient in B with thalamic and internal and external capsule involvement. This patient also has evidence of associated right occipital microhemorrhage (arrow in C). Both patients had the typical risk factors for PRES of acute kidney injury and hypertension.

Miller Fisher syndrome. A 36-year-old male patient with a history of COVID-19 and diplopia, ataxia, and areflexia. Axial T1 postcontrast (A) and coronal T2 fat-suppressed (B) MR images through the orbits demonstrate striking enlargement, enhancement, and T2 hyperintense signal of cranial nerve III (arrows in A and B). The patient was clinically diagnosed with Miller Fisher syndrome and improved with intravenous immunoglobulin treatment.