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Neuroimaging of Covid-19. First Insights based on Clinical Cases (Paperback, 1st ed. 2021)
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Neuroimaging of Covid-19. First Insights based on Clinical Cases (Paperback, 1st ed. 2021)
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This book presents the variability of the effects of Covid-19 on
the nervous system (NS), with the purpose to update content and
images based on improved scientific evidence. Current available
data show that involvement of the NS is frequent in patients with
SARS-CoV-2 infection. The most common neurologic syndromes include
cerebrovascular disorders, encephalopathies, inflammatory Central
Nervous System (CNS) syndromes, peripheral neurologic disorders,
psychiatric disorders. The pathophysiology of neurological
manifestations is far from being understood. They can be
coincidental, common complications of severe viral infection, or
direct consequence of the viral infection either via indirect
para-infective mechanisms or direct viral penetration of NS.
Experimental animal models had previously demonstrated the
neuroinvasive potential of SARS-CoV and the detection of viral
particles in special structures such as the thalamus, nucleus
ambiguous and nucleus of the solitary tract, suggesting that CNS
invasion can contribute significantly to the severe outcome not
only through direct damage to neurological structures, but also
through a potential detrimental effect on cardiorespiratory
responses. Up to now, the detection of SARS-CoV-2 RNA in the
cerebrospinal fluid of COVID-19 patients has been reported
occasionally and conclusive pathological demonstration of the virus
in the CNS is lacking. In this scenario, the role of neuroimaging
is fundamental. These considerations highlight the urgent need to
better clarify the neurotropic potential of the SARS-CoV-2 virus,
and to verify on human autoptic tissue the mechanisms demonstrated
in the experimental animal model in order to develop potential
strategies to prevent CNS invasion and to adapt treatment protocols
based on neurological involvement. CT scan is useful to detect
large hemorrhage and ischemic lesions, that have been reported in
Covid-19 patients, but lacks identifying other possible
neurological complications, such as microhemorrhage or
encephalitis. MRI could overcome these limitations; in particular
the use of specific sequences may reveal microvascular lesions that
can occur during the disease course, according to the described
pathogenesis. This book will be an invaluable tool for
neuroradiologists, radiologists, neurologists, and all physicians
involved in the pandemic.
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