World Neurosurg
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Thoracic spinal deformities may reduce chest wall compliance, leading to respiratory complications. The first SARS-CoV-2 (L-variant) strain caused critical respiratory illness, especially in vulnerable patients. This study investigates the association between scoliosis and SARS-CoV-2 (COVID-19) disease course severity. ⋯ Scoliosis was not an independent risk factor for critical COVID-19 illness. No trends indicated any consistent effect of degree of scoliosis on increased adverse outcome likelihood.
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A 45-year-old woman with chronic depression and currently receiving dual serotonergic therapy was transferred to our department with sudden dysbasia; she also reported an antecedent thunderclap headache. Magnetic resonance imaging (MRI) revealed a symmetrical bilateral acute infarction in the medial parietal lobe and severe vasoconstriction in the cerebral arteries. We diagnosed reversible cerebral vasoconstriction syndrome (RCVS) and stopped the serotonergic drug regimen. ⋯ Cerebral infarctions developed in 30%-40% of reversible cerebral vasoconstriction syndrome (RCVS) cases, mostly within watershed regions; however, these atypical infarctions were bilateral and symmetrical, potentially because of hypoperfusion caused by long-lasting severe vasoconstriction in the anterior cerebral arteries. Rare bilateral neurologic deficits can be mistaken for hypochondriac delusions, particularly in patients with depression. Since serotonergic drugs are the main cause of RCVS, primary care psychiatrists must be aware of drug-induced RCVS.