{
    "abstract": "During the COVID-19 outbreak, the presence of extensive white matter microhemorrhages was detected by brain MRIs. The goal of this study was to investigate the origin of this atypical hemorrhagic complication.\nBetween March 17 and May 18, 2020, 80 patients with severe COVID-19 infections were admitted for acute respiratory distress syndrome to intensive care units at the University Hospitals of Strasbourg for whom a brain MRI for neurologic manifestations was performed. 19 patients (24%) with diffuse microhemorrhages were compared to 18 control patients with COVID-19 and normal brain MRI.\nThe first hypothesis was hypoxemia. The latter seemed very likely since respiratory failure was longer and more pronounced in patients with microhemorrhages (prolonged endotracheal intubation (p\u2009=\u20090.0002), higher FiO\nBlood-brain barrier dysfunction secondary to hypoxemia and high concentration of uremic toxins seems to be the main mechanism leading to critical illness-associated cerebral microbleeds, and this complication remains to be frequently described in severe COVID-19 patients.",
    "authors": [
        {
            "affiliation": "H\u00f4pitaux Universitaires de Strasbourg, Service d'imagerie 2, H\u00f4pital de Hautepierre, 1 avenue Moli\u00e8re, 67200, Strasbourg, France.",
            "firstname": "Fran\u00e7ois",
            "initials": "F",
            "lastname": "Lersy"
        },
        {
            "affiliation": "H\u00f4pitaux Universitaires de Strasbourg, Service d'imagerie 2, H\u00f4pital de Hautepierre, 1 avenue Moli\u00e8re, 67200, Strasbourg, France.",
            "firstname": "Thibault",
            "initials": "T",
            "lastname": "Willaume"
        },
        {
            "affiliation": "Observatoire Fran\u00e7ais de La Scl\u00e9rose en Plaques, Lyon, France.",
            "firstname": "Jean-Christophe",
            "initials": "JC",
            "lastname": "Brisset"
        },
        {
            "affiliation": "H\u00f4pitaux Universitaires de Strasbourg, Service d'Anesth\u00e9sie-R\u00e9animation, Nouvel H\u00f4pital Civil, Strasbourg, France.",
            "firstname": "Olivier",
            "initials": "O",
            "lastname": "Collange"
        },
        {
            "affiliation": "H\u00f4pitaux Universitaires de Strasbourg, Service de M\u00e9decine Intensive R\u00e9animation, Nouvel H\u00f4pital Civil, Strasbourg, France.\nImmuno-Rhumatologie Mol\u00e9culaire, INSERM UMR_S1109, LabEx TRANSPLANTEX, Centre de Recherche D'Immunologie Et D'H\u00e9matologie, Facult\u00e9 de M\u00e9decine, F\u00e9d\u00e9ration Hospitalo-Universitaire (FHU) OMICARE, F\u00e9d\u00e9ration de M\u00e9decine Translationnelle de Strasbourg (FMTS), Universit\u00e9 de Strasbourg (UNISTRA), Strasbourg, France.",
            "firstname": "Julie",
            "initials": "J",
            "lastname": "Helms"
        },
        {
            "affiliation": "Service de M\u00e9decine Intensive R\u00e9animation, H\u00f4pitaux Universitaires de Strasbourg, Hautepierre, Strasbourg, France.",
            "firstname": "Francis",
            "initials": "F",
            "lastname": "Schneider"
        },
        {
            "affiliation": "H\u00f4pitaux Universitaires de Strasbourg, Service d'imagerie 2, H\u00f4pital de Hautepierre, 1 avenue Moli\u00e8re, 67200, Strasbourg, France.",
            "firstname": "Agathe",
            "initials": "A",
            "lastname": "Chammas"
        },
        {
            "affiliation": "Department of Hematology, Lille University Hospital - H\u00f4pital Claude Huriez, Lille, France.",
            "firstname": "Alexandre",
            "initials": "A",
            "lastname": "Willaume"
        },
        {
            "affiliation": "CHU de Strasbourg, Service de Sant\u00e9 Publique, GMRC, 67091, Strasbourg, France.",
            "firstname": "Nicolas",
            "initials": "N",
            "lastname": "Meyer"
        },
        {
            "affiliation": "Service de Neurologie, H\u00f4pitaux Universitaires de Strasbourg, Strasbourg, France.\nInstitut de G\u00e9n\u00e9tique Et de Biologie Mol\u00e9culaire Et Cellulaire (IGBMC), INSERM-U964/CNRS-UMR7104/Universit\u00e9 de Strasbourg, Illkirch, France.",
            "firstname": "Mathieu",
            "initials": "M",
            "lastname": "Anheim"
        },
        {
            "affiliation": "MRI Center, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France.\nUniversit\u00e9 Lyon 1, CREATIS-LRMN, CNRS/UMR/5220-INSERM U630, Villeurbanne, France.",
            "firstname": "Fran\u00e7ois",
            "initials": "F",
            "lastname": "Cotton"
        },
        {
            "affiliation": "H\u00f4pitaux Universitaires de Strasbourg, Service d'imagerie 2, H\u00f4pital de Hautepierre, 1 avenue Moli\u00e8re, 67200, Strasbourg, France. stephane.kremer@chru-strasbourg.fr.\nEngineering Science, Computer Science and Imaging Laboratory (ICube), Integrative Multimodal Imaging in Healthcare, UMR 7357, University of sStrasbourg-CNRS, Strasbourg, France. stephane.kremer@chru-strasbourg.fr.",
            "firstname": "St\u00e9phane",
            "initials": "S",
            "lastname": "Kremer"
        }
    ],
    "conclusions": null,
    "copyrights": "\u00a9 2020. Springer-Verlag GmbH Germany, part of Springer Nature.",
    "doi": "10.1007/s00415-020-10313-8\n10.1148/radiol.2020202040\n10.1148/radiol.2020202222\n10.1177/1971400920939229\n10.1148/radiol.2020202422\n10.1148/radiol.2020202791\n10.3174/ajnr.A6793\n10.1093/brain/awaa240\n10.1111/jon.12755\n10.2214/AJR.20.24364\n10.1007/s00401-020-02166-2\n10.1016/S0140-6736(20)31282-4\n10.1161/STROKEAHA.116.016289\n10.1007/s00330-020-06865-y\n10.1055/s-0037-1616068\n10.1038/jcbfm.2008.55\n10.1212/01.wnl.0000435563.84986.78\n10.1053/j.jvca.2017.03.001\n10.1212/WNL.0000000000001227\n10.1056/NEJMoa2015432\n10.1007/s12975-019-00698-8\n10.2176/nmc.45.556\n10.1093/brain/awh253",
    "journal": "Journal of neurology",
    "keywords": [
        "COVID-19",
        "Hypoxemia",
        "Kidney failure",
        "MRI",
        "Microhemorrhages"
    ],
    "methods": null,
    "publication_date": "2020-11-22",
    "pubmed_id": "33219827\n32437314\n32544034\n32757827\n32677875\n32729812\n32819899\n32637987\n32639679\n32903058\n32449057\n32505222\n28235962\n22797452\n32314058\n11816725\n18523438\n24107867\n28625752\n25666630\n32437596\n31055735\n16308513\n15282216",
    "results": "The first hypothesis was hypoxemia. The latter seemed very likely since respiratory failure was longer and more pronounced in patients with microhemorrhages (prolonged endotracheal intubation (p\u2009=\u20090.0002), higher FiO",
    "title": "Critical illness-associated cerebral microbleeds for patients with severe COVID-19: etiologic hypotheses.",
    "xml": "<Element 'PubmedArticle' at 0x788502dda480>"
}