Cerebrospinal fluid leakage after COVID-19: A pediatric case

Rika Tobiume , Yukihiko Konishi , Kosuke Koyano , Shinji Nakamura , Sae Nishisho , Takayuki Wakabayashi , Noriko Fuke , Ami Mizuo , Takuma Iwaki , Takashi Kusaka
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Abstract

Background

Various neurological and psychiatric symptoms have emerged after infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is the virus that causes coronavirus disease 2019 (COVID-19). These symptoms include exercise intolerance such as muscle weakness, fatigue, and pain as well as cognitive and mood disorders (brain fog). Further, frequent autonomic disorders such as hypotension and hypothermia have been recognized in adults and children, many of whom have been diagnosed with orthostatic dysregulation (OD). Some children with OD have developed cerebrospinal fluid leakage (CFL).

Case Presentation

Herein, we describe the case of a boy aged 9 years and 9 months who presented with orthostatic headaches, dizziness, and nausea. He was diagnosed with CFL after SARS-CoV-2 infection when a spinal MRI revealed an incomplete floating dural sac sign in the thoracic and lumbar spine. An epidural saline injection was administered, and he was discharged after his symptoms improved.

Discussion/Conclusion

The causes of CFL include trauma due to accidents or sports, or are idiopathic due to unknown causes. However, the onset of CFL might involve COVID-19. Understanding the relationship between COVID-19 and CFL onset may lead to better treatment outcomes for children with apparent symptoms of OD, such as orthostatic headaches, dizziness, and nausea, after contracting COVID-19.

COVID-19 后脑脊液漏:一个儿科病例
背景感染严重急性呼吸系统综合征冠状病毒 2(SARS-CoV-2)(即导致 2019 年冠状病毒病(COVID-19)的病毒)后,出现了各种神经和精神症状。这些症状包括运动不耐受,如肌肉无力、疲劳和疼痛,以及认知和情绪障碍(脑雾)。此外,成人和儿童经常出现低血压和低体温等自律神经失调,其中许多人被诊断为正张力失调(OD)。在此,我们描述了一个 9 岁零 9 个月的男孩的病例,他出现了正位性头痛、头晕和恶心。他在感染 SARS-CoV-2 后,脊柱磁共振成像显示胸椎和腰椎有不完整的硬膜囊漂浮征,因此被诊断为 CFL。讨论/结论 CFL 的病因包括事故或运动造成的外伤,或原因不明的特发性病因。然而,CFL的发病可能与COVID-19有关。了解 COVID-19 与 CFL 发病之间的关系,可能会为感染 COVID-19 后出现正压性头痛、头晕和恶心等明显 OD 症状的儿童带来更好的治疗效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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