key: cord-0901345-enhgno24
authors: Efe, Ibrahim Efecan; Aydin, Orhun Utku; Alabulut, Alper; Celik, Ozgur; Aydin, Kerameddin
title: COVID-19-associated encephalitis mimicking glial tumor: a case report.
date: 2020-05-29
journal: World Neurosurg
DOI: 10.1016/j.wneu.2020.05.194
sha: 80372dbf01600b2fb435fede85798a93cb6b88ad
doc_id: 901345
cord_uid: enhgno24

Abstract Background Reports on neurologic manifestations of coronavirus disease 2019 (COVID-19) have attracted broad attention. We present the unusual case of COVID-19-associated encephalitis mimicking a glial tumor. Case description A 35-year-old woman presented with headache and seizures. T2 fluid-attenuated inverse recovery imaging showed hyperintensities in the left temporal lobe. Magnetic resonance spectroscopy showed an elevated choline peak. Imaging findings were suggestive of high-grade glioma. Antiepileptic medication failed to achieve seizure control. Left anterior temporal lobectomy was performed. The patient had no post-operative deficits and her symptoms completely improved. Histological examination revealed encephalitis. Post-operatively, our patient was tested positive for COVID-19. Conclusions Our case raises awareness of neurologic manifestations of the disease and their potential to mimic glial tumors. For prompt diagnosis and prevention of transmission, clinicians should consider COVID-19 in patients with similar presentation.

In December 2019, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan, China, causing an outbreak of severe pneumonia. The resulting illness was named coronavirus disease 2019 and was recognized as pandemic in March 2020. Aside from typical symptoms such as cough, fever and difficulty in breathing, recent reports on neurologic manifestations have attracted broad attention. These included a case of acute necrotizing encephalopathy and a case of encephalitis which were likely caused by SARS-CoV-2. 1,2 Central nervous system (CNS) involvement had been seen in the 2002 outbreak of the SARS coronavirus before. 3 Here, we present a patient with COVID-19-associated encephalitis mimicking a glial tumor. To the best of our knowledge, this is the first case of surgical management and histopathological confirmation of encephalitis linked to COVID-19.

A 35-year-old woman was admitted to our neurosurgical department with headache, nausea, dizziness and drug-refractory seizures. She was alert, oriented and had no 

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