Abstract
Previous publications have discussed the occurrence of intracerebral hemorrhages, hallucinations and psychosis in COVID-19 patients. In this article, we have reviewed the literature on the subject while depicting the case of a 63-year-old female patient who suffered from an intracerebral hemorrhage in the right basal ganglia and thalamus two weeks after a COVID-19 diagnosis and who developed a visual hallucinosis shortly after. We concluded that, while there may be a correlation between COVID-19 and hallucinations according to current literature, more research is yet needed to clarify. In our case, we rather interpreted the hallucinations in the context of a peduncular hallucinosis related to the intracerebral hemorrhage. We compared our patient’s lesion localization to other 15 reported cases of peduncular hallucinations following intracerebral hemorrhages reported on Pubmed. In summary, the lesions were localized in the pons in 52.9% of the cases, 17.7% were in the thalamus and/or the basal ganglia, 17.7% in the mesencephalon and respectively 5.8% in the temporal and occipital lobe. The distribution pattern we found is consistent with the previously proposed mechanism behind peduncular hallucinations.
Highlights
The lesion pattern we found is consistent with the presumed mechanism behind peduncular hallucinosis described by Manford and Andermann [39] in their review on complex visual hallucinations
The presumed cell-invasion mechanism of SARS-CoV-2 suggests an increased vulnerability for intracerebral hemorrhages, yet the evidence at hand does not suffice to state a correlation between COVID-19 and ICH
We interpret the hallucinations our patient reported in the context of a peduncular hallucinosis following the intracerebral hemorrhage
Summary
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Hallucinations are defined as sensory perceptions in the absence of a corresponding external stimulus [1,2]. A causal relationship between psychosis and c infections has been discussed in the past and is still the object of controversial debates [9,10,11]. It is in light of this debate that we present the case of a 63-year-old female patient who developed an intracerebral hemorrhage and psychotic symptoms with visual hallucinations while suffering from a severe pneumonia following a SARS-CoV-2-infection. Based on our case report and the existing literature, we will briefly discuss the clinical features of and the possible mechanism behind COVID-19 related intracerebral hemorrhage, psychosis, hallucinations and a case-related selection of differential diagnoses
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
