{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T04:29:09Z","timestamp":1770352149437,"version":"3.49.0"},"reference-count":28,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"26","license":[{"start":{"date-parts":[[2022,12,26]],"date-time":"2022-12-26T00:00:00Z","timestamp":1672012800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,12,26]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Reports of cerebrovascular ischemia and stroke occurring as predominant neurological sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, which causes coronavirus disease 2019 (COVID-19), are increasingly evident within the literature. While various pathophysiological mechanisms have been postulated, including hypercoagulability, endothelial invasion, and systemic inflammation, discrete mechanisms for viral neurotropism remain unclear and controversial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>\n                      The authors present a unique case study of a 64-year-old male with acute COVID-19 infection and acute worsening of previously stable cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), a rare heritable arteriopathy due to mutation in the\n                      <jats:italic>Notch3<\/jats:italic>\n                      gene, which is critical for vascular development and tone. Delayed cranial neuropathies, brainstem fluid-attenuated inversion recovery signal, and enhancement of olfactory and vagus nerves on magnetic resonance neurography in this patient further support viral neurotropism via cranial nerves in addition to cerebral vasculature.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>To the authors\u2019 knowledge, this is the first case in the literature that not only demonstrates the consequences of COVID-19 infection in a patient with altered cerebrovascular autoregulation such as CADASIL but also highlights the tropism of SARS-CoV-2 for (1) cranial nerves as a mode of entry to the central nervous system and (2) vessels as a cause of cerebrovascular ischemia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case22413","type":"journal-article","created":{"date-parts":[[2022,12,26]],"date-time":"2022-12-26T02:54:45Z","timestamp":1672023285000},"source":"Crossref","is-referenced-by-count":3,"title":["Acute worsening of CADASIL in a patient with COVID-19 infection: illustrative case"],"prefix":"10.3171","volume":"4","author":[{"given":"Jared S.","family":"Rosenblum","sequence":"first","affiliation":[{"name":"Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessa M.","family":"Tunacao","sequence":"additional","affiliation":[{"name":"Department of Radiology, Stony Brook University Medical Center, Stony Brook, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew A.","family":"Nazari","sequence":"additional","affiliation":[{"name":"Internal Medicine and Pediatrics, Georgetown Hospital, Washington, District of Columbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Halle","family":"Ronk","sequence":"additional","affiliation":[{"name":"Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danielle D.","family":"Dang","sequence":"additional","affiliation":[{"name":"Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland"},{"name":"Department of Neurosurgery, Inova Fairfax Medical Campus, Inova Health System, Falls Church, Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chad","family":"Downing","sequence":"additional","affiliation":[{"name":"Department of Radiology, Stony Brook University Medical Center, Stony Brook, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhengping","family":"Zhuang","sequence":"additional","affiliation":[{"name":"Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John D.","family":"Heiss","sequence":"additional","affiliation":[{"name":"Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James G.","family":"Smirniotopoulos","sequence":"additional","affiliation":[{"name":"Department of Radiology, George Washington University, Washington, District of Columbia"},{"name":"MedPix\u00ae National Library of Medicine, Bethesda, Maryland; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Avraham","family":"Bluestone","sequence":"additional","affiliation":[{"name":"Department of Radiology, Stony Brook University Medical Center, Stony Brook, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Badia","sequence":"additional","affiliation":[{"name":"Department of Radiology, Stony Brook University Medical Center, Stony Brook, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph","family":"White","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Mather Hospital, Northwell Health System, Port Jefferson, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"6","key":"b1","series-title":"JAMA Neurol","doi-asserted-by":"publisher","first-page":"679","DOI":"10.1001\/jamaneurol.2020.1065","article-title":"The spectrum of neurologic disease in the severe acute respiratory syndrome coronavirus 2 pandemic infection: neurologists move to the frontlines","volume":"77","author":"Pleasure SJ","year":"2020","unstructured":"Pleasure SJ, Green AJ, Josephson SA. 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