In this paper, recently published in the American Journal of Neuroradiology, Franceschi et al. present 2 patients with COVID-19 infection who demonstrated imaging findings compatible with haemorrhagic posterior reversible encephalopathy syndrome (PRES). Although multi-factorial, PRES in hospitalised patients with COVID-19 may be explained by a combination of cytokine release syndrome and direct SARS-CoV-2–mediated breakdown of the blood–brain barrier (BBB), rendering patients susceptible to developing PRES, particularly in the setting of labile blood pressure. Despite significant radiological abnormalities, both patients survived and returned to normal mental status following the resolution of COVID-19-associated symptoms. The authors concluded that PRES may be a neurological manifestation of COVID-19 infection.
by Marialuisa Zedde and Francesco Cavallieri