Neuronophagia and microglial nodules in a SARS-CoV-2 patient with cerebellar hemorrhage
Abstract We document the neuropathologic findings of a 73-year old man who died from acute cerebellar hemorrhage in the context of relatively mild SARS-CoV2 infection. The patient developed sudden onset of headache, nausea, and vomiting, immediately followed by loss of consciousness on the day of ad...
| Main Authors: | , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2020-08-01
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| Series: | Acta Neuropathologica Communications |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s40478-020-01024-2 |
| _version_ | 1818112980213039104 |
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| author | Osama Al-Dalahmah Kiran T. Thakur Anna S. Nordvig Morgan L. Prust William Roth Angela Lignelli Anne-Catrin Uhlemann Emily Happy Miller Shajo Kunnath-Velayudhan Armando Del Portillo Yang Liu Gunnar Hargus Andrew F. Teich Richard A. Hickman Kurenai Tanji James E. Goldman Phyllis L. Faust Peter Canoll |
| author_facet | Osama Al-Dalahmah Kiran T. Thakur Anna S. Nordvig Morgan L. Prust William Roth Angela Lignelli Anne-Catrin Uhlemann Emily Happy Miller Shajo Kunnath-Velayudhan Armando Del Portillo Yang Liu Gunnar Hargus Andrew F. Teich Richard A. Hickman Kurenai Tanji James E. Goldman Phyllis L. Faust Peter Canoll |
| author_sort | Osama Al-Dalahmah |
| collection | DOAJ |
| description | Abstract We document the neuropathologic findings of a 73-year old man who died from acute cerebellar hemorrhage in the context of relatively mild SARS-CoV2 infection. The patient developed sudden onset of headache, nausea, and vomiting, immediately followed by loss of consciousness on the day of admission. Emergency medical services found him severely hypoxemic at home, and the patient suffered a cardiac arrest during transport to the emergency department. The emergency team achieved return of spontaneous circulation after over 17 min of resuscitation. A chest radiograph revealed hazy bilateral opacities; and real-time-PCR for SARS-CoV-2 on the nasopharyngeal swab was positive. Computed tomography of the head showed a large right cerebellar hemorrhage, with tonsillar herniation and intraventricular hemorrhage. One day after presentation, he was transitioned to comfort care and died shortly after palliative extubation. Autopsy performed 3 h after death showed cerebellar hemorrhage and acute infarcts in the dorsal pons and medulla. Remarkably, there were microglial nodules and neuronophagia bilaterally in the inferior olives and multifocally in the cerebellar dentate nuclei. This constellation of findings has not been reported thus far in the context of SARS-CoV-2 infection. |
| first_indexed | 2024-12-11T03:27:33Z |
| format | Article |
| id | doaj.art-49cc39dc32d249feb8e72859604afdfd |
| institution | Directory Open Access Journal |
| issn | 2051-5960 |
| language | English |
| last_indexed | 2024-12-11T03:27:33Z |
| publishDate | 2020-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Acta Neuropathologica Communications |
| spelling | doaj.art-49cc39dc32d249feb8e72859604afdfd2022-12-22T01:22:27ZengBMCActa Neuropathologica Communications2051-59602020-08-01811710.1186/s40478-020-01024-2Neuronophagia and microglial nodules in a SARS-CoV-2 patient with cerebellar hemorrhageOsama Al-Dalahmah0Kiran T. Thakur1Anna S. Nordvig2Morgan L. Prust3William Roth4Angela Lignelli5Anne-Catrin Uhlemann6Emily Happy Miller7Shajo Kunnath-Velayudhan8Armando Del Portillo9Yang Liu10Gunnar Hargus11Andrew F. Teich12Richard A. Hickman13Kurenai Tanji14James E. Goldman15Phyllis L. Faust16Peter Canoll17Department of Pathology and Cell Biology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center and the New York Presbyterian HospitalDepartment of Neurology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center and the New York Presbyterian HospitalDepartment of Neurology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center and the New York Presbyterian HospitalDepartment of Neurology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center and the New York Presbyterian HospitalDepartment of Neurology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center and the New York Presbyterian HospitalDepartment of Radiology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center and the New York Presbyterian HospitalDivision of Infectious Diseases, Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center and the New York Presbyterian HospitalDivision of Infectious Diseases, Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center and the New York Presbyterian HospitalDepartment of Pathology and Cell Biology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center and the New York Presbyterian HospitalDepartment of Pathology and Cell Biology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center and the New York Presbyterian HospitalDepartment of Pathology and Cell Biology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center and the New York Presbyterian HospitalDepartment of Pathology and Cell Biology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center and the New York Presbyterian HospitalDepartment of Pathology and Cell Biology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center and the New York Presbyterian HospitalDepartment of Pathology and Cell Biology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center and the New York Presbyterian HospitalDepartment of Pathology and Cell Biology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center and the New York Presbyterian HospitalDepartment of Pathology and Cell Biology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center and the New York Presbyterian HospitalDepartment of Pathology and Cell Biology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center and the New York Presbyterian HospitalDepartment of Pathology and Cell Biology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center and the New York Presbyterian HospitalAbstract We document the neuropathologic findings of a 73-year old man who died from acute cerebellar hemorrhage in the context of relatively mild SARS-CoV2 infection. The patient developed sudden onset of headache, nausea, and vomiting, immediately followed by loss of consciousness on the day of admission. Emergency medical services found him severely hypoxemic at home, and the patient suffered a cardiac arrest during transport to the emergency department. The emergency team achieved return of spontaneous circulation after over 17 min of resuscitation. A chest radiograph revealed hazy bilateral opacities; and real-time-PCR for SARS-CoV-2 on the nasopharyngeal swab was positive. Computed tomography of the head showed a large right cerebellar hemorrhage, with tonsillar herniation and intraventricular hemorrhage. One day after presentation, he was transitioned to comfort care and died shortly after palliative extubation. Autopsy performed 3 h after death showed cerebellar hemorrhage and acute infarcts in the dorsal pons and medulla. Remarkably, there were microglial nodules and neuronophagia bilaterally in the inferior olives and multifocally in the cerebellar dentate nuclei. This constellation of findings has not been reported thus far in the context of SARS-CoV-2 infection.http://link.springer.com/article/10.1186/s40478-020-01024-2Microglial nodulesNeuronophagiaSARS-CoV-2COVID-19Neuropathology |
| spellingShingle | Osama Al-Dalahmah Kiran T. Thakur Anna S. Nordvig Morgan L. Prust William Roth Angela Lignelli Anne-Catrin Uhlemann Emily Happy Miller Shajo Kunnath-Velayudhan Armando Del Portillo Yang Liu Gunnar Hargus Andrew F. Teich Richard A. Hickman Kurenai Tanji James E. Goldman Phyllis L. Faust Peter Canoll Neuronophagia and microglial nodules in a SARS-CoV-2 patient with cerebellar hemorrhage Acta Neuropathologica Communications Microglial nodules Neuronophagia SARS-CoV-2 COVID-19 Neuropathology |
| title | Neuronophagia and microglial nodules in a SARS-CoV-2 patient with cerebellar hemorrhage |
| title_full | Neuronophagia and microglial nodules in a SARS-CoV-2 patient with cerebellar hemorrhage |
| title_fullStr | Neuronophagia and microglial nodules in a SARS-CoV-2 patient with cerebellar hemorrhage |
| title_full_unstemmed | Neuronophagia and microglial nodules in a SARS-CoV-2 patient with cerebellar hemorrhage |
| title_short | Neuronophagia and microglial nodules in a SARS-CoV-2 patient with cerebellar hemorrhage |
| title_sort | neuronophagia and microglial nodules in a sars cov 2 patient with cerebellar hemorrhage |
| topic | Microglial nodules Neuronophagia SARS-CoV-2 COVID-19 Neuropathology |
| url | http://link.springer.com/article/10.1186/s40478-020-01024-2 |
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