{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:32:31Z","timestamp":1790641951283,"version":"4.1.0"},"reference-count":35,"publisher":"SAGE Publications","issue":"13","license":[{"start":{"date-parts":[[2020,11,1]],"date-time":"2020-11-01T00:00:00Z","timestamp":1604188800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,11,1]],"date-time":"2020-11-01T00:00:00Z","timestamp":1604188800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100006507","name":"Funda\u00e7\u00e3o Oswaldo Cruz","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006507","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Cephalalgia"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Headache is a frequent complaint in COVID-19 patients. However, no detailed information on headache characteristics is provided in these reports. Our objective is to describe the characteristics of headache and the cerebrospinal fluid (CSF) profile in COVID-19 patients, highlighting the cases of isolated intracranial hypertension.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this cross-sectional study, we selected COVID-19 patients who underwent lumbar puncture due to neurological complaints from April to May 2020. We reviewed clinical, imaging, and laboratory data of patients with refractory headache in the absence of other encephalitic or meningitic features. CSF opening pressures higher than 250\u2009mmH\n                      <jats:sub>2<\/jats:sub>\n                      O were considered elevated, and from 200 to 250\u2009mmH\n                      <jats:sub>2<\/jats:sub>\n                      O equivocal.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Fifty-six COVID-19 patients underwent lumbar puncture for different neurological conditions. A new, persistent headache that prompted a CSF analysis was diagnosed in 13 (23.2%). The pain was throbbing, holocranial or bilateral in the majority of patients. All patients had normal CSF analysis and RT-qPCR for SARS-CoV-2 was negative in all samples. Opening pressure &gt;200\u2009mmH\n                      <jats:sub>2<\/jats:sub>\n                      O was present in 11 patients and, in six of these, &gt;\u2009250\u2009mmH\n                      <jats:sub>2<\/jats:sub>\n                      O. 6\/13 patients had complete improvement of the pain, five had partial improvement, and two were left with a daily persistent headache.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In a significant proportion of COVID-19 patients, headache was associated to intracranial hypertension in the absence of meningitic or encephalitic features. Coagulopathy associated with COVID-19 could be an explanation, but further studies including post-mortem analysis of areas of production and CSF absorption (choroid plexuses and arachnoid granulations) are necessary to clarify this issue.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0333102420965963","type":"journal-article","created":{"date-parts":[[2020,11,4]],"date-time":"2020-11-04T05:46:04Z","timestamp":1604468764000},"page":"1452-1458","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":73,"title":["Isolated intracranial hypertension associated with COVID-19"],"prefix":"10.1177","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4479-4132","authenticated-orcid":false,"given":"Marcus Tulius T","family":"Silva","sequence":"first","affiliation":[{"name":"Evandro Chagas National Institute of Infectious Diseases (INI), FIOCRUZ, Brazilian Ministry of Health, Brazil"},{"name":"Neurology Department, Niteroi Hospital Complex, Niter\u00f3i, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco A","family":"Lima","sequence":"additional","affiliation":[{"name":"Evandro Chagas National Institute of Infectious Diseases (INI), FIOCRUZ, Brazilian Ministry of Health, Brazil"},{"name":"Neurology Section, Clementino Fraga Filho University Hospital, UFRJ, Rio de Janeiro"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guilherme","family":"Torezani","sequence":"additional","affiliation":[{"name":"Neurology Department, Fluminense Federal University (U.F.F.), Niter\u00f3i, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristiane N","family":"Soares","sequence":"additional","affiliation":[{"name":"Hospital Federal dos Servidores do Estado, Rio de Janeiro, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Dantas","sequence":"additional","affiliation":[{"name":"Eye Hospital, Niter\u00f3i, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos Ot\u00e1vio","family":"Brand\u00e3o","sequence":"additional","affiliation":[{"name":"Neurolife Laboratory, Rio de Janeiro, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ot\u00e1vio","family":"Esp\u00edndola","sequence":"additional","affiliation":[{"name":"Evandro Chagas National Institute of Infectious Diseases (INI), FIOCRUZ, Brazilian Ministry of Health, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marilda M","family":"Siqueira","sequence":"additional","affiliation":[{"name":"Laboratory of Respiratory Virus and Measles of the Oswaldo Cruz Institute (IOC), FIOCRUZ, Brazilian Ministry of Health, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abelardo QC","family":"Araujo","sequence":"additional","affiliation":[{"name":"Evandro Chagas National Institute of Infectious Diseases (INI), FIOCRUZ, Brazilian Ministry of Health, Brazil"},{"name":"Institute of Neurology, the Federal University of Rio de Janeiro (INDC-UFRJ), Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,11,4]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2020.1127"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/0333102417738202"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2002032"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30211-7"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(20)30086-4"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30183-5"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(20)30079-5"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m606"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000029570.69134.1B"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.33.10.1386"},{"key":"e_1_3_2_12_2","first-page":"129","article-title":"Papilledema and pseudotumor cerebri","volume":"14","author":"Friedman DI.","year":"2001","unstructured":"Friedman DI. Papilledema and pseudotumor cerebri. Ophthalmol Clin North Am 2001; 14: 129\u2013147, ix.","journal-title":". Ophthalmol Clin North Am"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3182a55f17"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1993.00540010072020"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1590\/0037-8682-0325-2020"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/00127893-200107010-00002"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1227\/00006123-198010000-00004"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.46.5.1226"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.51.1.245"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1331.2006.01279.x"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1991.00530160060014"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-2982.2008.01564.x"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1136\/adc.78.1.89"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1111\/dmcn.12475"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.62.4.407"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pediatrneurol.2013.03.007"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1177\/0883073814535500"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.accpm.2020.04.013"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.7326\/M20-2003"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02730810"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1111\/jth.14844"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2013-004376"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1526-4610.1997.3705286.x"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.44.2.357"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2020.05.016"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10072-020-04449-8"}],"container-title":["Cephalalgia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0333102420965963","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0333102420965963","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0333102420965963","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T14:43:27Z","timestamp":1777387407000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0333102420965963"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11]]},"references-count":35,"journal-issue":{"issue":"13","published-print":{"date-parts":[[2020,11]]}},"alternative-id":["10.1177\/0333102420965963"],"URL":"https:\/\/doi.org\/10.1177\/0333102420965963","relation":{},"ISSN":["0333-1024","1468-2982"],"issn-type":[{"value":"0333-1024","type":"print"},{"value":"1468-2982","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,11]]}}}