Article
Isolated intracranial hypertension associated with COVID-19
Registro en:
SILVA, Marcus Tulius T. et al. Isolated intracranial hypertension associated with COVID-19. Cephalalgia, v. 40, n. 13, p. 1452-1458, 2020.
0333-1024
10.1177/0333102420965963
Autor
Silva, Marcus Tulius T.
Lima, Marco A.
Torezani, Guilherme
Soares, Cristiane N.
Dantas, Claudia
Brandão, Carlos Otávio
Espíndola, Otávio
Siqueira, Marilda Agudo Mendonça Teixeira de
Araujo, Abelardo Q. C.
Resumen
A Rede Genômica Fiocruz é formada por especialistas de todas as unidades da Fundação no país e de institutos parceiros que se empenham diariamente em gerar dados mais robustos sobre o comportamento do SARS-Cov-2 e contribuir para um melhor preparo do país no enfrentamento da pandemia em termos de diagnóstico mais precisos e vacinas eficazes. Saiba mais sobre a Rede Genômica Fiocruz em: http://www.genomahcov.fiocruz.br/ Background: Headache is a frequent complaint in COVID-19 patients. However, no detailed information on headache characteristics is provided in these reports. Our objective is to describe the characteristics of headache and the cerebrospinal fluid (CSF) profile in COVID-19 patients, highlighting the cases of isolated intracranial hypertension. Methods: In this cross-sectional study, we selected COVID-19 patients who underwent lumbar puncture due to neurological complaints from April to May 2020. We reviewed clinical, imaging, and laboratory data of patients with refractory headache in the absence of other encephalitic or meningitic features. CSF opening pressures higher than 250 mmH2O were considered elevated, and from 200 to 250 mmH2O equivocal. Results: Fifty-six COVID-19 patients underwent lumbar puncture for different neurological conditions. A new, persistent headache that prompted a CSF analysis was diagnosed in 13 (23.2%). The pain was throbbing, holocranial or bilateral in the majority of patients. All patients had normal CSF analysis and RT-qPCR for SARS-CoV-2 was negative in all samples. Opening pressure >200 mmH2O was present in 11 patients and, in six of these, > 250 mmH2O. 6/13 patients had complete improvement of the pain, five had partial improvement, and two were left with a daily persistent headache.
Conclusions: In a significant proportion of COVID-19 patients, headache was associated to intracranial hypertension in
the absence of meningitic or encephalitic features. Coagulopathy associated with COVID-19 could be an explanation,
but further studies including post-mortem analysis of areas of production and CSF absorption (choroid plexuses and
arachnoid granulations) are necessary to clarify this issue.