COVID-19−Associated Encephalitis Mimicking Glial Tumor

• Published in: World neurosurgery Vol. 140; pp. 46 - 48
• Main Authors: Efe, Ibrahim E., Aydin, Orhun Utku, Alabulut, Alper, Celik, Ozgur, Aydin, Kerameddin
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.08.2020
• Subjects: Adult; Betacoronavirus - pathogenicity; Coronavirus; Coronavirus Infections - complications; Coronavirus Infections - pathology; COVID-19; Diagnosis, Differential; Encephalitis; Encephalitis - diagnosis; Encephalitis - pathology; Encephalitis - virology; Female; Glioma - diagnosis; Glioma - pathology; Headache - virology; Humans; Pandemics; Pneumonia, Viral - complications; Pneumonia, Viral - pathology; SARS-CoV-2; Seizures - pathology; Seizures - virology; Spectroscopy; Temporal Lobe - pathology; Temporal Lobe - virology; COVID-19; Encephalitis; Spectroscopy; SARS-CoV-2; Coronavirus; MRI; CNS; FLAIR; SARS; MERS; MRS
• ISSN: 1878-8750; 1878-8769
• DOI: 10.1016/j.wneu.2020.05.194

Reports on neurologic manifestations of coronavirus disease 2019 (COVID-19) have attracted broad attention. We present an unusual case of COVID-19−associated encephalitis mimicking a glial tumor. 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. A left anterior temporal lobectomy was performed. The patient had no postoperative deficits, and her symptoms completely improved. Histologic examination revealed encephalitis. Postoperatively, our patient tested positive for COVID-19. 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.