Figure 4.

CNS vasculitis like changes in a 56-year-old male patient with COVID-19 severe ARDS. He was intubated with stabilization of pulmonary function and oxygen saturation, blood pressure was controlled, and coagulation panel was normalized. He remained drowsy and non-arousable. MRI axial DWI and ADC, (a, b) at the ventricular level, and (c, d) at supraventricular level showing left frontoparietal periventricular and multilobar bilateral deep subcortical recent lacunar infracts with diffusion restriction with punctate and nodular foci of bright DWI and corresponding low signal on ADC (arrows in a–d). The intracranial MRA (f) showed normal appearance of arteries. ADC, apparent diffusion coefficient; ARDS, acute respiratory distress syndrome; CNS, central nervous system; DWI, diffusion-weighted image; MRA,MR angiography.