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<meta name="HW.identifier" content="/ajnr/42/2/279.atom" />
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<meta name="DC.Title" content="Serial Imaging of Virus-Associated Necrotizing Disseminated Acute Leukoencephalopathy (VANDAL) in COVID-19" />
<meta name="DC.Identifier" content="10.3174/ajnr.A6898" />
<meta name="DC.Date" content="2021-02-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="© 2021 by American Journal of Neuroradiology. Indicates open access to non-subscribers at www.ajnr.org" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Various patterns of leukoencephalopathy have been described in coronavirus disease 2019 (COVID-19). In this article, we aimed to describe the clinical and imaging features of acute disseminated leukoencephalopathy in critically ill patients with COVID-19 and the imaging evolution during a short-term follow-up.

MATERIALS AND METHODS: We identified and reviewed the clinical data, laboratory results, imaging findings, and outcomes for 8 critically ill patients with COVID-19 with acute disseminated leukoencephalopathy.

RESULTS: All patients demonstrated multiple areas of white matter changes in both cerebral hemispheres; 87.5% (7/8) of patients had a posterior predilection. Four patients (50%) had short-term follow-up imaging within a median of 17 days after the first MR imaging; they developed brain atrophy, and their white matter lesions evolved into necrotizing cystic cavitations. All (8/8) patients had inflammatory cytokine release syndrome as demonstrated by elevated interleukin-6, D-dimer, lactate dehydrogenase, erythrocyte sedimentation rate, C-reactive protein, and ferritin levels. Most (7/8; 87.5%) patients were on prolonged ventilator support (median, 44.5 days; interquartile range, 20.5 days). These patients had poor functional outcomes (6/8 [75%] patients were discharged with mRS 5) and high mortality (2/8, 25%).

CONCLUSIONS: Critically ill patients with COVID-19 can develop acute disseminated leukoencephalopathy that evolves into cystic degeneration of white matter lesions with brain atrophy during a short period, which we dubbed virus-associated necrotizing disseminated acute leukoencephalopathy. This may be the result of COVID-19-related endothelial injury, cytokine storm, or thrombotic microangiopathy.

ADEM
:   acute disseminated encephalomyelitis
ARDS
:   acute respiratory distress syndrome
CRP
:   C-reactive protein
COVID-19
:   coronavirus disease 2019
ESR
:   erythrocyte sedimentation rate
GCS
:   Glasgow Coma Scale
IL-6
:   interleukin-6
INR
:   international normalized ratio
IQR
:   interquartile range
LDH
:   lactate dehydrogenase
PRES
:   posterior reversible encephalopathy syndrome
SARS-CoV-2
:   Severe Acute Respiratory Syndrome coronavirus 2
VANDAL
:   Virus Associated Necrotizing Disseminated Acute Leukoencephalopathy
WM
:   white matter" />
<meta name="DC.Contributor" content="S. Agarwal" />
<meta name="DC.Contributor" content="J. Conway" />
<meta name="DC.Contributor" content="V. Nguyen" />
<meta name="DC.Contributor" content="S. Dogra" />
<meta name="DC.Contributor" content="P. Krieger" />
<meta name="DC.Contributor" content="D. Zagzag" />
<meta name="DC.Contributor" content="A. Lewis" />
<meta name="DC.Contributor" content="K. Melmed" />
<meta name="DC.Contributor" content="S. Galetta" />
<meta name="DC.Contributor" content="R. Jain" />
<meta name="article:published_time" content="2021-02-01" />
<meta name="article:section" content="Adult Brain" />
<meta name="citation_title" content="Serial Imaging of Virus-Associated Necrotizing Disseminated Acute Leukoencephalopathy (VANDAL) in COVID-19" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Various patterns of leukoencephalopathy have been described in coronavirus disease 2019 (COVID-19). In this article, we aimed to describe the clinical and imaging features of acute disseminated leukoencephalopathy in critically ill patients with COVID-19 and the imaging evolution during a short-term follow-up.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;We identified and reviewed the clinical data, laboratory results, imaging findings, and outcomes for 8 critically ill patients with COVID-19 with acute disseminated leukoencephalopathy.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;All patients demonstrated multiple areas of white matter changes in both cerebral hemispheres; 87.5% (7/8) of patients had a posterior predilection. Four patients (50%) had short-term follow-up imaging within a median of 17 days after the first MR imaging; they developed brain atrophy, and their white matter lesions evolved into necrotizing cystic cavitations. All (8/8) patients had inflammatory cytokine release syndrome as demonstrated by elevated interleukin-6, D-dimer, lactate dehydrogenase, erythrocyte sedimentation rate, C-reactive protein, and ferritin levels. Most (7/8; 87.5%) patients were on prolonged ventilator support (median, 44.5 days; interquartile range, 20.5 days). These patients had poor functional outcomes (6/8 [75%] patients were discharged with mRS 5) and high mortality (2/8, 25%).&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;Critically ill patients with COVID-19 can develop acute disseminated leukoencephalopathy that evolves into cystic degeneration of white matter lesions with brain atrophy during a short period, which we dubbed virus-associated necrotizing disseminated acute leukoencephalopathy. This may be the result of COVID-19-related endothelial injury, cytokine storm, or thrombotic microangiopathy.&lt;/p&gt;" />
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<meta name="twitter:title" content="Serial Imaging of Virus-Associated Necrotizing Disseminated Acute Leukoencephalopathy (VANDAL) in COVID-19" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Various patterns of leukoencephalopathy have been described in coronavirus disease 2019 (COVID-19). In this article, we aimed to describe the clinical and imaging features of acute disseminated leukoencephalopathy in critically ill patients with COVID-19 and the imaging evolution during a short-term follow-up.

MATERIALS AND METHODS: We identified and reviewed the clinical data, laboratory results, imaging findings, and outcomes for 8 critically ill patients with COVID-19 with acute disseminated leukoencephalopathy.

RESULTS: All patients demonstrated multiple areas of white matter changes in both cerebral hemispheres; 87.5% (7/8) of patients had a posterior predilection. Four patients (50%) had short-term follow-up imaging within a median of 17 days after the first MR imaging; they developed brain atrophy, and their white matter lesions evolved into necrotizing cystic cavitations. All (8/8) patients had inflammatory cytokine release syndrome as demonstrated by elevated interleukin-6, D-dimer, lactate dehydrogenase, erythrocyte sedimentation rate, C-reactive protein, and ferritin levels. Most (7/8; 87.5%) patients were on prolonged ventilator support (median, 44.5 days; interquartile range, 20.5 days). These patients had poor functional outcomes (6/8 [75%] patients were discharged with mRS 5) and high mortality (2/8, 25%).

CONCLUSIONS: Critically ill patients with COVID-19 can develop acute disseminated leukoencephalopathy that evolves into cystic degeneration of white matter lesions with brain atrophy during a short period, which we dubbed virus-associated necrotizing disseminated acute leukoencephalopathy. This may be the result of COVID-19-related endothelial injury, cytokine storm, or thrombotic microangiopathy.

ADEM
:   acute disseminated encephalomyelitis
ARDS
:   acute respiratory distress syndrome
CRP
:   C-reactive protein
COVID-19
:   coronavirus disease 2019
ESR
:   erythrocyte sedimentation rate
GCS
:   Glasgow Coma Scale
IL-6
:   interleukin-6
INR
:   international normalized ratio
IQR
:   interquartile range
LDH
:   lactate dehydrogenase
PRES
:   posterior reversible encephalopathy syndrome
SARS-CoV-2
:   Severe Acute Respiratory Syndrome coronavirus 2
VANDAL
:   Virus Associated Necrotizing Disseminated Acute Leukoencephalopathy
WM
:   white matter" />
<meta name="og-title" property="og:title" content="Serial Imaging of Virus-Associated Necrotizing Disseminated Acute Leukoencephalopathy (VANDAL) in COVID-19" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/42/2/279" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Various patterns of leukoencephalopathy have been described in coronavirus disease 2019 (COVID-19). In this article, we aimed to describe the clinical and imaging features of acute disseminated leukoencephalopathy in critically ill patients with COVID-19 and the imaging evolution during a short-term follow-up.

MATERIALS AND METHODS: We identified and reviewed the clinical data, laboratory results, imaging findings, and outcomes for 8 critically ill patients with COVID-19 with acute disseminated leukoencephalopathy.

RESULTS: All patients demonstrated multiple areas of white matter changes in both cerebral hemispheres; 87.5% (7/8) of patients had a posterior predilection. Four patients (50%) had short-term follow-up imaging within a median of 17 days after the first MR imaging; they developed brain atrophy, and their white matter lesions evolved into necrotizing cystic cavitations. All (8/8) patients had inflammatory cytokine release syndrome as demonstrated by elevated interleukin-6, D-dimer, lactate dehydrogenase, erythrocyte sedimentation rate, C-reactive protein, and ferritin levels. Most (7/8; 87.5%) patients were on prolonged ventilator support (median, 44.5 days; interquartile range, 20.5 days). These patients had poor functional outcomes (6/8 [75%] patients were discharged with mRS 5) and high mortality (2/8, 25%).

CONCLUSIONS: Critically ill patients with COVID-19 can develop acute disseminated leukoencephalopathy that evolves into cystic degeneration of white matter lesions with brain atrophy during a short period, which we dubbed virus-associated necrotizing disseminated acute leukoencephalopathy. This may be the result of COVID-19-related endothelial injury, cytokine storm, or thrombotic microangiopathy.

ADEM
:   acute disseminated encephalomyelitis
ARDS
:   acute respiratory distress syndrome
CRP
:   C-reactive protein
COVID-19
:   coronavirus disease 2019
ESR
:   erythrocyte sedimentation rate
GCS
:   Glasgow Coma Scale
IL-6
:   interleukin-6
INR
:   international normalized ratio
IQR
:   interquartile range
LDH
:   lactate dehydrogenase
PRES
:   posterior reversible encephalopathy syndrome
SARS-CoV-2
:   Severe Acute Respiratory Syndrome coronavirus 2
VANDAL
:   Virus Associated Necrotizing Disseminated Acute Leukoencephalopathy
WM
:   white matter" />
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    <div class="highwire-article-citation highwire-citation-type-highwire-article node88779--5" data-node-nid="88779" id="top-node-88779--61331017946" data-pisa="ajnr;42/2/279" data-pisa-master="ajnr;ajnr.A6898" data-apath="/ajnr/42/2/279.atom" data-hw-author-tooltip-instance="highwire_author_tooltip"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-article-title-complete clearfix has-author-tooltip highwire-citation-highwire-article-top-a">
  
  
      <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">Serial Imaging of Virus-Associated Necrotizing Disseminated Acute Leukoencephalopathy (VANDAL) in COVID-19</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">S. Agarwal</span>, <span class="highwire-citation-author" data-delta="1">J. Conway</span>, <span class="highwire-citation-author" data-delta="2">V. Nguyen</span>, <span class="highwire-citation-author" data-delta="3">S. Dogra</span>, <span class="highwire-citation-author" data-delta="4">P. Krieger</span>, <span class="highwire-citation-author" data-delta="5">D. Zagzag</span>, <span class="highwire-citation-author" data-delta="6">A. Lewis</span>, <span class="highwire-citation-author" data-delta="7">K. Melmed</span>, <span class="highwire-citation-author" data-delta="8">S. Galetta</span> and <span class="highwire-citation-author" data-delta="9">R. Jain</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">February 2021,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">42 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(2) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">279-284; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A6898 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-88779--61331017946" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">S. Agarwal </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Neurology (S.A., J.C., A.L., K.M., S.G.)</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=S.%2BAgarwal%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=Agarwal%20S&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%3AS.%2BAgarwal%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/0000-0001-5097-416X" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for S. Agarwal</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">J. Conway </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Neurology (S.A., J.C., A.L., K.M., S.G.)</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=J.%2BConway%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=Conway%20J&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%3AJ.%2BConway%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/0000-0002-0218-9770" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for J. Conway</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">V. Nguyen </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Radiology (V.N., S.D., P.K., R.J.)</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=V.%2BNguyen%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=Nguyen%20V&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%3AV.%2BNguyen%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/0000-0002-3023-1593" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for V. Nguyen</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">S. Dogra </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Radiology (V.N., S.D., P.K., R.J.)</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=S.%2BDogra%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=Dogra%20S&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%3AS.%2BDogra%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/0000-0003-2386-7849" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for S. Dogra</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">P. Krieger </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Radiology (V.N., S.D., P.K., R.J.)</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.%2BKrieger%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=Krieger%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.%2BKrieger%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/0000-0002-3563-5941" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for P. Krieger</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">D. Zagzag </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Pathology (D.Z.)</div><div class='author-affiliation'><span class='nlm-sup'>d</span>Neurosurgery (D.Z., A.L., K.M., R.J.), NYU Langone Health, New York, New York</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=D.%2BZagzag%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=Zagzag%20D&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%3AD.%2BZagzag%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/0000-0002-2331-0613" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for D. Zagzag</a></li></ul></div><div class="author-tooltip-6"><div class="author-tooltip-name">A. Lewis </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Neurology (S.A., J.C., A.L., K.M., S.G.)</div><div class='author-affiliation'><span class='nlm-sup'>d</span>Neurosurgery (D.Z., A.L., K.M., R.J.), NYU Langone Health, New York, New York</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=A.%2BLewis%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=Lewis%20A&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%3AA.%2BLewis%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/0000-0002-0756-7320" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for A. Lewis</a></li></ul></div><div class="author-tooltip-7"><div class="author-tooltip-name">K. Melmed </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Neurology (S.A., J.C., A.L., K.M., S.G.)</div><div class='author-affiliation'><span class='nlm-sup'>d</span>Neurosurgery (D.Z., A.L., K.M., R.J.), NYU Langone Health, New York, New York</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=K.%2BMelmed%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=Melmed%20K&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%3AK.%2BMelmed%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/0000-0003-4084-8586" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for K. 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Galetta </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Neurology (S.A., J.C., A.L., K.M., S.G.)</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=S.%2BGaletta%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=Galetta%20S&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%3AS.%2BGaletta%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/0000-0003-3781-7324" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for S. Galetta</a></li></ul></div><div class="author-tooltip-9"><div class="author-tooltip-name">R. Jain </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Radiology (V.N., S.D., P.K., R.J.)</div><div class='author-affiliation'><span class='nlm-sup'>d</span>Neurosurgery (D.Z., A.L., K.M., R.J.), NYU Langone Health, New York, New York</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=R.%2BJain%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=Jain%20R&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%3AR.%2BJain%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/0000-0002-4879-0457" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for R. 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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-42.2.279.1" data-doi="10.1016/j.ajem.2020.05.024"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Bridwell</span>  <span class="cit-name-given-names">R</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Long</span>  <span class="cit-name-given-names">B</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Gottlieb</span>  <span class="cit-name-given-names">M</span></span></li></ol><cite>. <span class="cit-article-title">Neurologic complications of COVID-19</span>. <abbr class="cit-jnl-abbrev">Am J Emerg Med</abbr> <span class="cit-pub-date">2020</span>;<span class="cit-vol">38</span>:<span class="cit-fpage">1549.e3</span>–<span class="cit-lpage">49.e7</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>10.1016/j.ajem.2020.05.024</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>32425321</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1016/j.ajem.2020.05.024&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=32425321&amp;link_type=MED&amp;atom=%2Fajnr%2F42%2F2%2F279.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li><li><span class="ref-label">2.</span><a 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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 42</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 2 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Feb 2021 </div></div>
      
      
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      <div class="highwire-cite-title">Serial Imaging of Virus-Associated Necrotizing Disseminated Acute Leukoencephalopathy (VANDAL) in 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">S.</span> <span class="nlm-surname">Agarwal</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">J.</span> <span class="nlm-surname">Conway</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">V.</span> <span class="nlm-surname">Nguyen</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">S.</span> <span class="nlm-surname">Dogra</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">P.</span> <span class="nlm-surname">Krieger</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">D.</span> <span class="nlm-surname">Zagzag</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">A.</span> <span class="nlm-surname">Lewis</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">K.</span> <span class="nlm-surname">Melmed</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">S.</span> <span class="nlm-surname">Galetta</span></span>, <span class="highwire-citation-author" data-delta="9"><span class="nlm-given-names">R.</span> <span class="nlm-surname">Jain</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">Feb 2021, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">42 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(2) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">279-284; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A6898 </span></div>
  
  
  
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