Subject(s)
Central Nervous System Vascular Malformations , Humans , Central Nervous System Vascular Malformations/diagnostic imaging , Central Nervous System Vascular Malformations/complications , Spinal Cord/diagnostic imaging , Spinal Cord/blood supply , Male , Magnetic Resonance Imaging , Female , Middle AgedABSTRACT
ABSTRACT: The SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) pandemic has revealed diverse neurological manifestations of coronavirus disease 2019 (COVID-19). This case report begins with a background review of the neurological effects of COVID-19, focusing on stroke, neuroinflammation, and coagulopathy. It then describes the clinical course and autopsy findings of a young patient presenting with COVID-19-associated stroke. The formal neuropathological examination is presented, along with the systemic and brain histological features. Interesting aspects include multiterritory hemorrhagic infarctions, microinfarcts throughout the cortex and white matter, and prominent mixed inflammatory cell cuffing of intracerebral blood vessels distant from the infarcts.
Subject(s)
COVID-19/complications , Infarction, Middle Cerebral Artery/pathology , Stroke/etiology , Stroke/pathology , Adult , Brain/pathology , Brain Death , Female , Humans , Infarction, Middle Cerebral Artery/diagnostic imaging , Lung/pathology , Lymphocytes/pathology , Macrophages/pathology , Monocytes/pathology , Pulmonary Edema/pathology , Tomography, X-Ray ComputedABSTRACT
Background. A subgroup of MS patients present with "euphoria." Classical authors describe this symptom as the predominant mood state of these patients, while contemporary authors regard it as rare. Objective. This study aimed to address these discrepancies and investigate the contributions made by varying operational definitions and measurement instruments. Methods. One hundred MS patients and 100 matched controls completed the classical interview of Cottrell and Wilson and the modern Neuropsychiatric Inventory in a once-off interview. Results. The MS group demonstrated high frequencies of euphoria using the classical measure but low frequencies using the contemporary measure and definition. The matched control group demonstrated significantly higher rates than the MS group using the classical measure and lower rates than the MS group using the contemporary measure. Conclusion. The discrepancies in incidence rates of euphoria noted in the literature do not reflect a change in the incidence of euphoria in MS, but rather in the definition and operationalisation of "euphoria." Furthermore, these results highlight the importance of characterising what represents pathological euphoria as well as the need for better definitions and instruments of measure.
ABSTRACT
A recent interest in euphoria in multiple sclerosis (MS) has resulted in a wealth of literature on this topic. However, a marked change in the definition of this symptom appears to have taken place since its first descriptions in the mid-19(th) century. This short report will demonstrate that the 'euphoria' being studied today may not be the same state as that originally observed and described in MS patients and some implications of this possibility are discussed.