Is the brain spared in Crimean-Congo haemorrhagic fever? An MR-SWI study to reveal CNS involvement

The aim of this prospective study is to investigate the central nervous system involvement in Crimean-Congo haemorrhagic fever (CCHF) with magnetic resonance imaging (MRI) in conjunction with clinical and laboratory findings. Between July 2015 and August 2016, 36 patients with CCHF were undergone brain MRI including SWI. Two MRIs, one at the time of admission and the second in the convalescent period, were performed for each patient in order to see if there is any sign of central nervous system (CNS) involvement, especially in terms of intracranial haemorrhage or viral encephalitis. Clinical severity scoring was also done and laboratory findings were noted in order to correlate with clinical and imaging findings. None of the 36 patients showed any MRI findings of an acute intracranial event during the course of the disease. There was a significant difference between mild cases and moderate cases in terms of some laboratory parameters (p < 0.05). Although CCHF is a highly lethal disease which involves multiple organs and systems, CNS involvement seems to be extremely rare in mild and moderate cases. aEuro cent MRI is the imaging method of choice to diagnose microbleeds and encephalitis aEuro cent Although CCHF causes multisystem bleeding, intracranial haemorrhage seems to be very rare aEuro cent CNS complications are uncommon, even in the setting of suggestive symptoms aEuro cent Death usually results from extracranial bleeding and multiorgan failure aEuro cent Severity scoring is associated with some laboratory abnormalities in CCHF.