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<meta name="DC.Title" content="Neuroimaging Findings in Patients with COVID-19" />
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<meta name="DC.Description" content="SUMMARY: Little is known about the neurologic sequelae of coronavirus disease 2019 (COVID-19). We assessed neuroimaging findings in 4 patients positive for COVID-19. All had abnormal mental status, deranged coagulation parameters, and markedly elevated D-dimer levels. CT/MR imaging showed a common pattern of multifocal subcortical/cortical petechial-type hemorrhages, while SWI showed more extensive multifocal abnormalities. The appearances are consistent with a thrombotic microangiopathy and may be due to the heightened level of thrombosis in patients with COVID-19.

COVID-19
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ECMO
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SARS-CoV-2
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&lt;p&gt;Little is known about the neurologic sequelae of coronavirus disease 2019 (COVID-19). We assessed neuroimaging findings in 4 patients positive for COVID-19. All had abnormal mental status, deranged coagulation parameters, and markedly elevated D-dimer levels. CT/MR imaging showed a common pattern of multifocal subcortical/cortical petechial-type hemorrhages, while SWI showed more extensive multifocal abnormalities. The appearances are consistent with a thrombotic microangiopathy and may be due to the heightened level of thrombosis in patients with COVID-19.&lt;/p&gt;" />
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COVID-19
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      <div class="highwire-cite-overline"><span  class="highwire-cite-metadata-article-type highwire-cite-metadata">Research Article</span><span class="separator-pipe"></span><span  class="highwire-cite-metadata-art-cat highwire-cite-metadata"><span class="wrapper">Adult Brain</span></span></div>
  
      <div class="highwire-cite-access"><span class="highwire-citation-access"><i class="highwire-access-icon highwire-access-icon-open-access open-access hw-icon-open-access" title="Open Access" aria-hidden="true"></i><span  class="element-invisible highwire-access-icon highwire-access-icon-open-access" style="">Open Access</span></span></div>
  
      <h1 class="highwire-cite-title" id="page-title">Neuroimaging Findings in Patients with COVID-19</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">P. Nicholson</span>, <span class="highwire-citation-author" data-delta="1">L. Alshafai</span> and <span class="highwire-citation-author" data-delta="2">T. Krings</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">August 2020,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">41 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(8) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1380-1383; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A6630 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-77463--6359282765" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">P. Nicholson </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Division of Neuroradiology (P.N., T.K.), Joint Department of Medical Imaging, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=P.%2BNicholson%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Nicholson%20P&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AP.%2BNicholson%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0001-7182-5112" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for P. Nicholson</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">L. Alshafai </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Head and Neck Imaging (L.A.), Mount Sinai and University Health Network, University of Toronto, Toronto, Ontario, Canada.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=L.%2BAlshafai%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Alshafai%20L&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AL.%2BAlshafai%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-6030-8539" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for L. Alshafai</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">T. Krings </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Division of Neuroradiology (P.N., T.K.), Joint Department of Medical Imaging, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=T.%2BKrings%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Krings%20T&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AT.%2BKrings%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0001-6321-5787" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for T. Krings</a></li></ul></div></div></div>  </div>

  
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    <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" xmlns:xhtml="http://www.w3.org/1999/xhtml" class="section ref-list" id="ref-list-1"><h2 class="">References</h2><ol class="cit-list ref-use-labels"><li><span class="ref-label">1.</span><a class="rev-xref-ref" href="#xref-ref-1-1" title="View reference 1. in text" id="ref-1">↵</a><div class="cit ref-cit ref-journal" id="cit-41.8.1380.1" data-doi="10.1148/radiol.2020201629"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Oudkerk</span>  <span class="cit-name-given-names">M</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Büller</span>  <span class="cit-name-given-names">HR</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Kuijpers</span>  <span class="cit-name-given-names">D</span></span>, <span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">Diagnosis, prevention, and treatment of thromboembolic complications in COVID-19: report of the National Institute for Public Health of the Netherlands</span>. <abbr class="cit-jnl-abbrev">Radiology</abbr> <span class="cit-pub-date">2020</span> <span class="cit-month">Apr</span> <span class="cit-day">23</span>. 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[<span class="cit-comment">Epub ahead of print</span>]<span class="cit-pub-id-sep cit-pub-id-doi-sep"> </span><span class="cit-pub-id cit-pub-id-doi"><span class="cit-pub-id-scheme-doi">doi:</span>10.1001/jama.2020.6775</span><span class="cit-pub-id-sep cit-pub-id-pmid-sep"> </span><span class="cit-pub-id cit-pub-id-pmid"><span class="cit-pub-id-scheme-pmid">pmid:</span>32320003</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1001/jama.2020.6775&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=32320003&amp;link_type=MED&amp;atom=%2Fajnr%2F41%2F8%2F1380.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li><li><span class="ref-label">17.</span><a class="rev-xref-ref" href="#xref-ref-17-1" title="View reference 17. in text" id="ref-17">↵</a><div class="cit ref-cit ref-journal" id="cit-41.8.1380.17" data-doi="10.1001/archneurol.2011.209"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Mateen</span>  <span class="cit-name-given-names">FJ</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Muralidharan</span>  <span class="cit-name-given-names">R</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Shinohara</span>  <span class="cit-name-given-names">RT</span></span>, <span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">Neurological injury in adults treated with extracorporeal membrane oxygenation</span>. <abbr class="cit-jnl-abbrev">Arch Neurol</abbr> <span class="cit-pub-date">2011</span>;<span class="cit-vol">68</span>:<span class="cit-fpage">1543</span>–<span class="cit-lpage">49</span><span class="cit-pub-id-sep cit-pub-id-doi-sep"> </span><span class="cit-pub-id cit-pub-id-doi"><span class="cit-pub-id-scheme-doi">doi:</span>10.1001/archneurol.2011.209</span><span class="cit-pub-id-sep cit-pub-id-pmid-sep"> </span><span class="cit-pub-id cit-pub-id-pmid"><span class="cit-pub-id-scheme-pmid">pmid:</span>21825216</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1001/archneurol.2011.209&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=21825216&amp;link_type=MED&amp;atom=%2Fajnr%2F41%2F8%2F1380.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a><a href="/lookup/external-ref?access_num=000297993500007&amp;link_type=ISI" class="cit-ref-sprinkles cit-ref-sprinkles-newisilink cit-ref-sprinkles-webofscience"><span>Web of Science</span></a></div></div></li><li><span class="ref-label">18.</span><a class="rev-xref-ref" href="#xref-ref-18-1" title="View reference 18. in text" id="ref-18">↵</a><div class="cit ref-cit ref-journal" id="cit-41.8.1380.18" data-doi="10.1164/rccm.201411-2118LE"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Guennec</span>  <span class="cit-name-given-names">LL</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Bertrand</span>  <span class="cit-name-given-names">A</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Laurent</span>  <span class="cit-name-given-names">C</span></span>, <span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">Diffuse cerebral microbleeds after extracorporeal membrane oxygenation support</span>. <abbr class="cit-jnl-abbrev">Am J Respir Crit Care Med</abbr> <span class="cit-pub-date">2015</span>;<span class="cit-vol">191</span>:<span class="cit-fpage">594</span>–<span class="cit-lpage">96</span><span class="cit-pub-id-sep cit-pub-id-doi-sep"> </span><span class="cit-pub-id cit-pub-id-doi"><span class="cit-pub-id-scheme-doi">doi:</span>10.1164/rccm.201411-2118LE</span><span class="cit-pub-id-sep cit-pub-id-pmid-sep"> </span><span class="cit-pub-id cit-pub-id-pmid"><span class="cit-pub-id-scheme-pmid">pmid:</span>25723825</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1164/rccm.201411-2118LE&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=25723825&amp;link_type=MED&amp;atom=%2Fajnr%2F41%2F8%2F1380.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li></ol></div></div>  </div>

  
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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 41</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 8 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Aug 2020 </div></div>
      
      
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    <div class="highwire-article-citation highwire-citation-type-highwire-article node77463--3" data-node-nid="77463" id="share-node-77463--4287429765" data-pisa="ajnr;41/8/1380" data-pisa-master="ajnr;ajnr.A6630" data-apath="/ajnr/41/8/1380.atom"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-standard clearfix">
  
  
  
  
      <div class="highwire-cite-title">Neuroimaging Findings in Patients with COVID-19</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">P.</span> <span class="nlm-surname">Nicholson</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">L.</span> <span class="nlm-surname">Alshafai</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">T.</span> <span class="nlm-surname">Krings</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-oa-ind highwire-cite-metadata"><i class="highwire-oa-indicator"></i> </span><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Aug 2020, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">41 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(8) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1380-1383; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A6630 </span></div>
  
  
  
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