{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T10:55:04Z","timestamp":1766400904080,"version":"build-2065373602"},"reference-count":15,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2022,7,10]],"date-time":"2022-07-10T00:00:00Z","timestamp":1657411200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>The presence of neurological symptoms within the clinical range of COVID-19 disease infection has increased. This paper presents the situation of a 45-year-old man having the medical antecedent diabetes mellitus, who presented to the emergency department with fever, headache, and respiratory symptoms, nine days following vaccination with the Ad26.COV2-S COVID-19 vaccine. The patient tested positive for SARS-CoV-2 based on nasal polymerase chain reaction (RT-PCR). Two weeks after the presentation, he developed Tolosa\u2013Hunt Syndrome, an autoimmune phenomenon, with painful left ophthalmoplegia. Significant improvement was seen in terms of his discomfort; however, ptosis and ocular mobility improved only moderately after treatment with intravenous methylprednisolone, and the patient was discharged on a new insulin regimen. The patient returned after four weeks and the neurological exam results showed significant signs of right hemiparesis, mixed aphasia, incomplete left ophthalmoplegia, severe headache, and agitation; after a few days, the patient experienced a depressed level of consciousness and coma. The patient\u2019s clinical condition worsened and, unfortunately, he died. MRI brain images revealed multiple ischemic strokes, meningitis, infectious vasculitis, and hemorrhagic encephalitis, which are all serious complications of COVID-19.<\/jats:p>","DOI":"10.3390\/brainsci12070902","type":"journal-article","created":{"date-parts":[[2022,7,10]],"date-time":"2022-07-10T21:19:28Z","timestamp":1657487968000},"page":"902","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Tolosa\u2013Hunt Syndrome and Hemorrhagic Encephalitis Presenting in a Patient after COVID-19 Vaccination Followed by COVID-19 Infection"],"prefix":"10.3390","volume":"12","author":[{"given":"Anca Elena","family":"Gogu","sequence":"first","affiliation":[{"name":"Department of Neurology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Centre for Cognitive Research in Neuropsychiatric Pathology (Neuropsy-Cog), Faculty of Medicine, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, 300041 Timi\u0219oara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7090-7677","authenticated-orcid":false,"given":"Andrei Gheorghe","family":"Motoc","sequence":"additional","affiliation":[{"name":"Department of Anatomy and Embryology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8525-3554","authenticated-orcid":false,"given":"Any","family":"Docu Axelerad","sequence":"additional","affiliation":[{"name":"Department of Neurology, General Medicine Faculty, \u201cOvidius\u201d University, 900470 Constanta, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7584-5188","authenticated-orcid":false,"given":"Alina Zorina","family":"Stroe","sequence":"additional","affiliation":[{"name":"Department of Neurology, General Medicine Faculty, \u201cOvidius\u201d University, 900470 Constanta, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreea Alexandra","family":"Gogu","sequence":"additional","affiliation":[{"name":"\u201cVictor Babes\u201d, Medicine Faculty, University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7827-818X","authenticated-orcid":false,"given":"Dragos Catalin","family":"Jianu","sequence":"additional","affiliation":[{"name":"Department of Neurology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Centre for Cognitive Research in Neuropsychiatric Pathology (Neuropsy-Cog), Faculty of Medicine, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, 300041 Timi\u0219oara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,7,10]]},"reference":[{"key":"ref_1","unstructured":"Bradley, W.G., Darroff, R.B., Fenichel, G.M., and Marsden, C.D. (1991). Neurology in Clinical Practice: V. 2: Principles of Diagnosis and Management, Butterworth-Heinemann."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"25158163221078977","DOI":"10.1177\/25158163221078977","article-title":"Tolosa-Hunt Syndrome after COVID-19 Infection","volume":"5","author":"Etheridge","year":"2022","journal-title":"Cephalalgia Rep."},{"key":"ref_3","first-page":"e16791","article-title":"Tolosa-Hunt Syndrome Presenting after COVID-19 Vaccination","volume":"13","author":"Chuang","year":"2021","journal-title":"Cureus"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Gogu, A.E., Motoc, A.G., Stroe, A.Z., Docu Axelerad, A., Docu Axelerad, D., P\u00e2rv, F., Munteanu, G., Dan, F., and Jianu, D.C. (2021). Clinical Spectrum and Neuroimagistic Features in Hospitalized Patients with Neurological Disorders and Concomitant Coronavirus-19 Infection. 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Radiol."},{"key":"ref_13","first-page":"e1060","article-title":"Neurologic Manifestations in Hospitalized Patients with COVID-19: The ALBACOVID Registry","volume":"95","year":"2020","journal-title":"Neurology"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"261","DOI":"10.3892\/etm.2022.11187","article-title":"Neurological Manifestations Found in Children with Multisystem Inflammatory Syndrome","volume":"23","author":"Mihai","year":"2022","journal-title":"Exp. Ther. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e46","DOI":"10.1016\/S2213-2600(20)30216-2","article-title":"COVID-19 Cytokine Storm: The Interplay between Inflammation and Coagulation","volume":"8","author":"Jose","year":"2020","journal-title":"Lancet Respir. Med."}],"container-title":["Brain Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-3425\/12\/7\/902\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:47:36Z","timestamp":1760140056000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-3425\/12\/7\/902"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,10]]},"references-count":15,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2022,7]]}},"alternative-id":["brainsci12070902"],"URL":"https:\/\/doi.org\/10.3390\/brainsci12070902","relation":{},"ISSN":["2076-3425"],"issn-type":[{"type":"electronic","value":"2076-3425"}],"subject":[],"published":{"date-parts":[[2022,7,10]]}}}