SARS-CoV-2 in CSF

Abstract

Infectious encephalitis due to SARS-CoV-2 is rare, why such cases need to be extensively examined to learn more about the behaviour of the virus in the CNS. To confirm the diagnosis it is mandatory that cerebral computed tomography (CCT) and cerebral magnetic resonance imaging (MRI) are carried out without contrast medium. Application of contrast medium eventually allows to localise the infected cerebral lesion and to study the progression of the lesion. If patients with encephalitis present with headache and elevated D-dimer it is mandatory to rule out venous sinus thrombosis (VST). VST is a common complication of SARS-CoV-2 infections and often manifests with seizures in addition to behavioural changes and headache. VST can be most easily excluded by magnetic resonance venography (MRV) with contrast medium or with computed tomography venography. If patients with encephalitis present with behavioural changes, confusion, drowsiness, and disorientation, it is also mandatory to rule out non-convulsive status epilepticus

Keywords

Infection, SARS-CoV-2, encephalitis, cerebrospinal fluid, brain