BRAIN IMAGING (CT & MRI) IN CHILDREN WITH MULTI INFLAMMATORY SYSTEMIC SYNDROME (MIS-C)
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Keywords
Multi Inflammatory Systemic Syndrome, Brain Imaging, children
Abstract
Background: Multi Inflammatory Systemic Syndrome (MIS-C) has been identified in multiple countries impacted by the COVID-19 pandemic. MRI is valuable for assessing neurologic deficits after MIS-C and can help guide treatment decisions. The aim of this study is to assess the clinical and radiological findings of brain involvement in children with SARS-CoV-2 infection and MISC.
Methods: This cross-sectional observational study was conducted at PICU of our institution, including 25 children diagnosed as MIS-C clinically and laboratory (according to CDC &WHO guidelines) with neurological signs and symptoms (including irritability, GCS disturbances and others).
Collected data included brain imaging by CT and MRI studies showing abnormal signals within both cerebral hemispheres, brain stem and cerebellum.
Results: This study included 25 patients. All diagnosed as MIS-C with neurological signs and symptoms. All patients underwent brain imaging including CT and/or MRI studies. About 60% of cases have positive findings. CT examinations were normal in 15 patients and revealed brain alterations in seven (31.8%). MRI findings were the nonspecific hyperintense signal in T2WI and FLAIR and restricted diffusion in DWI (80% and 73.3% respectively), followed by the ischemic infarctions that represent 47.7% of examined cases. Hemorrhage that was represented in one case.
Conclusions: Some children with MIS-C showed brain involvement and were presented with neurological symptoms involving both the central and peripheral nervous systems. On imaging, they were represented with different cerebral, cerebellar and brain stem lesions that mainly show nonspecific hyperintense signal in T2WI &FLAIR and restricted diffusion in DWI by MRI examination as well as hypodense areas by CT examination.
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
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Eman Mohamed Fahmy
Department of Pediatrics, Faculty of Medicine, Sohag University, Sohag, Egypt.
Ahmed M. Khalaf-Awad
Department of Diagnostic and Intervention Radiology, Faculty of Medicine, South Valley
University, Qena 83523, Egypt
Mohammed Abdelaal M Bakheet
Department of Pediatrics, Faculty of Medicine, Sohag University, Sohag, Egypt.
Youstena Rashed Atyia
Department of Pediatrics, Faculty of Medicine, Sohag University, Sohag, Egypt.