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Proceedings SNO “Percorsi clinici in Neuroscienze”

Figure 1. Brain MRI
showing bilateral hyper-
intensity of medial ol-
factory striae on T2
3D FLAIR.

DISCUSSION

This report shows an unprecedented cortical hyperin-
tensity in the medial olfactory striae on 3D FLAIR
MRI in a patient with persistent cacosmia and phan-
tosmia 14 months after SARS-Cov2 infection, sup-
porting the hypothesis of SARS-Cov2 neurotropic
propagation through the olfactory system.
Interestingly, the treatment with Carbamazepine
seemed to reduce the phantosmia episodes, reinforc-
ing the hypothesis of a focal structural alteration in-
volving the olfactory striae. Collaterally to the olfac-
tory dysfunction, the patient also developed a new
onset of mood and cognitive impairment which could
suggest a more complex involvement of CNS after
SARS-Cov2 infection. Patients with persistent olfac- 3. Aragão MFVV, Leal MC, Cartaxo Filho OQ, Fonseca
tory impairment should be carefully monitored for TM, Valença MM. Anosmia in COVID-19 associated
long term neurological sequelae. with injury to the olfactory bulbs evident on MRI. AJNR
Am J Neuroradiol 2020; 41 (9): 1703-1706.
4. Tsivgoulis G, Fragkou PC, Lachanis S, Palaiodimou L,
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avirus disease 2019 (COVID-19) and anosmia. JAMA ry system and their implications. Lancet Neurol 2021; 20
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