MRI DIAGNOSIS OF ENCEPHALITIS ASSOCIATED WITH SARS-COV-2 (CLINICAL OBSERVATIONS)
Encephalitis is an inflammatory process in the membranes of the brain and the brain substance itself, by nature it can be infectious - viral, bacterial, as well as autoimmune, post-traumatic, allergic. On April 3, the International Journal of Inftctious Diseases published an article by the Japanese authors of the Journal Pre-Prof "The first case of meningitis/encephalitis associated with the SARS-Co-2 virus". This publication describes a clinical case in which a patient with a clinical diagnosis of meningitis and viral infection was diagnosed with ventriculitis of the right lateral ventricle, changes in the hippocampus, in the medial temporal lobe complex, pansinusitis of the paranasal sinuses on an MRI examination conducted 20 hours after admission to the clinic, which suggested encephalitis. Differential diagnosis was performed with hippocampal sclerosis or post-convulsive encephalitis (the patient has a history of epilepsy). Currently, it is already obvious that the SARS-CoV-2 virus penetrates the central nervous system, involves the respiratory center in the pathological process, and causes neurological disorders. The virus can penetrate the blood-brain barrier through the blood or trans-synaptic pathway and affect the neurons of the brain stem. Neurological manifestations are not leading in the clinical picture of diseases caused by coronaviruses. Nevertheless, there is evidence of possible lesions of the nervous system and their role in the development of respiratory, sensory, motor, autonomic and other disorders of the central and peripheral nervous systems, while SARS-CoV-2 infection cannot be excluded even with negative results of PCR of nasopharyngeal smears. It should be taken into account that unconscious patients are potentially infected with the new coronavirus. In order to detect hidden COVID-19 patients, it should be borne in mind that the symptoms of encephalitis or cerebropathy may be the first symptoms, as well as respiratory manifestations. Timely CT and MRI examinations are an important step for early diagnosis of infection and to prevent the spread of a pandemic.