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코로나19 백신 접종 후에 발생한 가역뇌량팽대병변

Reversible Lesion in Splenium of Corpus Callosum Following COVID-19 Vaccination

Article information

J Korean Neurol Assoc. 2022;40(2):202-203
Publication date (electronic) : May 1, 2022
doi : http://dx.doi.org/10.17340/jkna.2022.2.22
Seong-il Oh, MD,a,b
aDepartment of Neurology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
bNeuroimmunology Research Group, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
오성일,a,b
a인제대학교 의과대학 부산백병원 신경과
b신경면역연구회
Address for correspondence: Seong-il Oh, MD Department of Neurology, Busan Paik Hospital, Inje University College of Medicine, 75 Bokji-ro, Busanjin-gu, Busan 47392, Korea Tel: +82-51-890-6130 Fax: +82-51-895-6367 E-mail: seongil.oh@gmail.com
*

This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT) (No. 2020R1G1A1008446).

received : December 13, 2021 , rev-recd : January 3, 2022 , accepted : January 3, 2022 .

26세 여자가 3주 전 발생한 상하지의 심한 근육통으로 방문하였다. 환자는 증상 발생 1일 전 화이자 코로나19 백신(BNT162b2) 1차 접종을 받았다. 접종 다음 날부터 발생한 팔다리 감각이상, 근육통 및 통증 연관 근력저하로 인해 보행이 어려운 상태였다. 증상 발생 후 타원에 입원하여 보존 치료를 받음에도 증상 호전이 없어 본원으로 전원되었다. 전원 후 1주일간 보존 치료 중 단기기억장애와 단어찾기장애가 갑자기 발생하여 뇌 자기공명영상을 촬영하였고, 확산강조영상과 T2강조영상에서 뇌량 팽대에 저명한 고신호강도 병변이 나타났다(Fig. 1). 2달 뒤 추적 뇌 자기공명영상에서는 이전의 병변은 사라졌다(Fig. 2). 뇌량 팽대 병변은 코로나19 감염증에서 발견되기도 하지만[1], 코로나19 백신 접종 이후에서도 드물게 보고되기 때문에 다양한 신경계 합병증으로써 임상의의 주의를 필요로 한다[2].

Figure 1.

Brain magnetic resonance imaging (MRI) in the patient. Brain MRI images show round restricted diffusion (A) with low apparent diffusion coefficient values (B) within the splenium of the corpus callosum, suggesting a cytotoxic lesion of the corpus callosum. This lesion corresponds to abnormal increased signal on T2-weighted image (C) and hypointense lesion on T1-weighted image (D).

Figure 2.

Follow-up magnetic resonance imaging 2 months later show complete resolution of the lesion of the corpus callosum on diffusion-weighted image (A), apparent diffusion coefficient map (B), T2-weighted image (C), and T1-weighted image (D).

References

1. Moreau A, Ego A, Vandergheynst F, Taccone FS, Sadeghi N, Montesinos I, et al. Cytotoxic lesions of the corpus callosum (CLOCCs) associated with SARS-CoV-2 infection. J Neurol 2021;268:1592–1594.
2. Youn T, Yang H. Cytotoxic lesion of the corpus callosum (CLOCCs) after SARS-CoV-2 mRNA vaccination. J Korean Med Sci 2021;36:e228.

Article information Continued

Copyright © 2022 Korean Neurological Association

Figure 1.

Figure 1.

Brain magnetic resonance imaging (MRI) in the patient. Brain MRI images show round restricted diffusion (A) with low apparent diffusion coefficient values (B) within the splenium of the corpus callosum, suggesting a cytotoxic lesion of the corpus callosum. This lesion corresponds to abnormal increased signal on T2-weighted image (C) and hypointense lesion on T1-weighted image (D).

Figure 2.

Figure 2.

Follow-up magnetic resonance imaging 2 months later show complete resolution of the lesion of the corpus callosum on diffusion-weighted image (A), apparent diffusion coefficient map (B), T2-weighted image (C), and T1-weighted image (D).