Acute Necrotic Hemorrhagic Leukoencephalitis related to COVID-19: a report of two cases.

Alqahtani, Alwaleed; Alaklabi, Aeed; Kristjansson, Stefan; Alharthi, Hanan; aldhilan, Suhayb; Alam, Hamid

Acute necrotic hemorrhagic leukoencephalitis (ANHLE) is a sub-form of acute disseminating leukoencephalitis which is a post viral or vaccination uncommon disease with poor prognosis. Radiological findings include multiple or diffuse lesions involving the white matter and sparing the cortex with or without rim enhancement. In addition to areas of hemorrhages with possible involvement of basal ganglia and thalami. We describe the imaging findings for two cases of ANHLE; a 59 years old male and a 47 years old female. Both of them were tested positive of SARS-Covid2 with presentation of consciousness loss and respiratory failure. CT and MRI brain show global white matter changes associated with acute hemorrhagic necrosis, although uncommon, are compatible with post-viral acute necrotic hemorrhagic leukoencephalitis with end point of death for the first patient and coma for the second patient.