Subdural effusion associated with COVID-19 encephalopathy: A case report

Abstract

BACKGROUND

The precise mechanism by which severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) impacts the central nervous system remains unclear, with manifestations spanning from mild symptoms (e.g., olfactory and gustatory deficits, hallucinations, and headache) to severe complications (e.g., stroke, seizures, encephalitis, and neurally demyelinating lesions). The occurrence of single-pass subdural effusion, as described below, is extremely rare.

CASE SUMMARY

A 56-year-old male patient presented with left-sided limb weakness and slurred speech as predominant clinical symptoms. Through comprehensive imaging and diagnostic assessments, he was diagnosed with cerebral infarction complicated by hemorrhagic transformation affecting the right frontal, temporal, and parietal regions. In addition, an intracranial infection with SARS-CoV-2 was identified during the rehabilitation process; consequently, an idiopathic subdural effusion developed. Remarkably, the subdural effusion underwent absorption within 6 d, with no recurrence observed during the 3-month follow-up.

CONCLUSION

Subdural effusion is a potentially rare intracranial complication associated with SARS-CoV-2 infection.

Keywords: Cerebral infarction; Hemorrhagic transformation; Subdural effusion; COVID-19 encephalopathy; Novel coronavirus infection; Brain fog; Case report

Core Tip: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may transmit via the retrograde axonal pathway, bloodstream, or direct penetration through the blood-brain barrier, exerting its effects on angiotensin-converting enzyme-2 receptors. This intricate interaction can cause neurological complications, including subdural effusion, which is very rare. Clinical vigilance is advised for cranial imaging in individuals with SARS-CoV-2 infection to enhance diagnostic precision. Considering its unique characteristics, subdural effusion, a seldom reported complication, warrants attention.