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      Posterior reversible encephalopathy syndrome in a child with severe multisystem inflammatory syndrome due to COVID-19

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          Abstract

          Posterior reversible encephalopathy syndrome is a rare clinical and radiological syndrome characterized by vasogenic edema of the white matter of the occipital and parietal lobes, which are usually symmetrical, resulting from a secondary manifestation of acute dysfunction of the posterior cerebrovascular system. We describe a case of posterior reversible encephalopathy syndrome secondary to SARS-CoV-2 infection in a 9-year-old boy who developed acute hypoxemic respiratory failure and required assisted mechanical ventilation. The child developed multisystem inflammatory syndrome, and he was monitored in the pediatric intensive care unit and was provided mechanical ventilation and vasoactive agents for hemodynamic support. Additionally, he developed pulmonary and extrapulmonary clinical manifestations along with neuropsychiatric manifestations that required close follow-up and were verified using brain magnetic resonance imaging for timely intervention. Currently, there are few reports of children with posterior reversible encephalopathy syndrome associated with multisystem inflammatory syndrome.

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          Most cited references10

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          Posterior reversible encephalopathy syndrome, part 1: fundamental imaging and clinical features.

          Posterior reversible encephalopathy syndrome (PRES) is a neurotoxic state coupled with a unique CT or MR imaging appearance. Recognized in the setting of a number of complex conditions (preeclampsia/eclampsia, allogeneic bone marrow transplantation, organ transplantation, autoimmune disease and high dose chemotherapy) the imaging, clinical and laboratory features of this toxic state are becoming better elucidated. This review summarizes the basic and advanced imaging features of PRES, along with pertinent features of the clinical and laboratory presentation and available histopathology. Many common imaging/clinical/laboratory observations are present among these patients, despite the perception of widely different associated clinical conditions.
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            Neurological Disease as a Failure of Brain-Immune Crosstalk: The Multiple Faces of Neuroinflammation.

            Neuroinflammation is common to various diseases of the central nervous system (CNS), but its imprecise definition has led to many misconceptions in research and clinical approaches. It is now recognized that neuroinflammation in chronic neurodegenerative conditions, including Alzheimer's disease (AD) and age-related dementia, is distinct from the inflammation that accompanies relapsing-remitting multiple sclerosis (RRMS), and its experimental animal model, experimental autoimmune encephalomyelitis (EAE). Here, we discuss the discrete features of inflammation in different CNS pathologies, given the current understanding of the CNS-immune crosstalk; the roles of the immune cells that are involved, their phenotypes, and their location and route of entry to the CNS. Understanding the term neuroinflammation to encompass a broad range of disease-specific conditions is essential for finding effective therapeutic approaches for these pathologies.
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              Vessel Wall Enhancement and Focal Cerebral Arteriopathy in a Pediatric Patient with Acute Infarct and COVID-19 Infection

              Herein, we report the findings of intracranial arterial wall enhancement, consistent with focal cerebral arteriopathy-inflammatory type, in a child presenting with acute infarct in the setting of coronavirus disease 2019 (COVID-19) infection. To our knowledge, this report provides the first description of vessel wall imaging findings in COVID-19-associated acute stroke.
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                Author and article information

                Journal
                Rev Bras Ter Intensiva
                Rev Bras Ter Intensiva
                rbti
                Revista Brasileira de Terapia Intensiva
                Associação de Medicina Intensiva Brasileira - AMIB
                0103-507X
                1982-4335
                Apr-Jun 2022
                Apr-Jun 2022
                : 34
                : 2
                : 295-299
                Affiliations
                [1 ] Department of Pediatric, Hospital Nacional Edgardo Rebagliati Martins - Lima, Peru.
                [2 ] Evidencias en Salud, Universidad San Ignacio de Loyola - Lima, Peru.
                [3 ] Department of Pediatric, Instituto Nacional de Salud del Niño - San Borja, Peru.
                [4 ] Department of Pediatric, Instituto Nacional de Salud del Niño - Lima, Peru.
                Author notes
                Corresponding author: Jesus Angel Dominguez-Rojas, Department of Pediatric, Hospital Nacional Edgardo Rebagliati Martins, Av. Edgardo Regabliati, 490, Lima, Peru, E-mail: jesusdominguez24@ 123456gmail.com
                Author information
                http://orcid.org/0000-0001-6141-6622
                http://orcid.org/0000-0001-8283-6669
                http://orcid.org/0000-0002-2683-5693
                http://orcid.org/0000-0001-6360-1362
                http://orcid.org/0000-0001-5182-6863
                Article
                10.5935/0103-507X.20220028-pt
                9354113
                35946661
                38068e0d-e108-4842-8cc2-30dcaf98c36e

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 10 October 2021
                : 17 December 2021
                Categories
                Case Report

                covid-19,coronavirus infections,sars-cov-2,brain diseases,systemic inflammatory response syndrome,child,intensive care units,pediatric

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