Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Apr 6, 2024; 12(10): 1799-1803
Published online Apr 6, 2024. doi: 10.12998/wjcc.v12.i10.1799
Subdural effusion associated with COVID-19 encephalopathy: A case report
Zhi-Yuan Xue, Zhong-Lin Xiao, Ming Cheng, Tao Xiang, Xiao-Li Wu, Qiao-Ling Ai, Yang-Ling Wu, Tao Yang
Zhi-Yuan Xue, Ming Cheng, Tao Xiang, Xiao-Li Wu, Qiao-Ling Ai, Yang-Ling Wu, Tao Yang, Department of Rehabilitation Medicine, Chengdu Jinniu District People’s Hospital, Chengdu 610000, Sichuan Province, China
Zhong-Lin Xiao, Department of Rehabilitation Medicine, The General Hospital of the Western Theater Command of the People’s Liberation Army of China, Chengdu 610000, Sichuan Province, China
Author contributions: All authors made a significant contribution to the work reported, whether that was in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; all authors took part in drafting, revising, or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.
Informed consent statement: The study participant provided written informed consent before enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Ming Cheng, MD, PhD, Director, Department of Rehabilitation Medicine, Chengdu Jinniu District People’s Hospital, No. 389 Huazhaobi Road, Jinniu District, Chengdu 610000, Sichuan Province, China.
Received: November 16, 2023
Peer-review started: November 16, 2023
First decision: December 26, 2023
Revised: January 7, 2024
Accepted: March 8, 2024
Article in press: March 8, 2024
Published online: April 6, 2024

The precise mechanism by which severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) impacts the central nervous system remains unclear, with manifestations spanning from mild symptoms (e.g., olfactory and gustatory deficits, hallucinations, and headache) to severe complications (e.g., stroke, seizures, encephalitis, and neurally demyelinating lesions). The occurrence of single-pass subdural effusion, as described below, is extremely rare.


A 56-year-old male patient presented with left-sided limb weakness and slurred speech as predominant clinical symptoms. Through comprehensive imaging and diagnostic assessments, he was diagnosed with cerebral infarction complicated by hemorrhagic transformation affecting the right frontal, temporal, and parietal regions. In addition, an intracranial infection with SARS-CoV-2 was identified during the rehabilitation process; consequently, an idiopathic subdural effusion developed. Remarkably, the subdural effusion underwent absorption within 6 d, with no recurrence observed during the 3-month follow-up.


Subdural effusion is a potentially rare intracranial complication associated with SARS-CoV-2 infection.

Keywords: Cerebral infarction, Hemorrhagic transformation, Subdural effusion, COVID-19 encephalopathy, Novel coronavirus infection, Brain fog, Case report

Core Tip: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may transmit via the retrograde axonal pathway, bloodstream, or direct penetration through the blood-brain barrier, exerting its effects on angiotensin-converting enzyme-2 receptors. This intricate interaction can cause neurological complications, including subdural effusion, which is very rare. Clinical vigilance is advised for cranial imaging in individuals with SARS-CoV-2 infection to enhance diagnostic precision. Considering its unique characteristics, subdural effusion, a seldom reported complication, warrants attention.