We document the neuropathologic findings of a 73-year old man who died from acute cerebellar hemorrhage in the context of relatively mild SARS-CoV2 infection. The patient developed sudden onset of headache, nausea, and vomiting, immediately followed by loss of consciousness on the day of admission. Emergency medical services found him severely hypoxemic at home, and the patient suffered a cardiac arrest during transport to the emergency department. The emergency team achieved return of spontaneous circulation after over 17 min of resuscitation. A chest radiograph revealed hazy bilateral opacities; and real-time-PCR for SARS-CoV-2 on the nasopharyngeal swab was positive. Computed tomography of the head showed a large right cerebellar hemorrhage, with tonsillar herniation and intraventricular hemorrhage. One day after presentation, he was transitioned to comfort care and died shortly after palliative extubation. Autopsy performed 3 h after death showed cerebellar hemorrhage and acute infarcts in the dorsal pons and medulla. Remarkably, there were microglial nodules and neuronophagia bilaterally in the inferior olives and multifocally in the cerebellar dentate nuclei. This constellation of findings has not been reported thus far in the context of SARS-CoV-2 infection.

中文翻译：

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患有小脑出血的 SARS-CoV-2 患者的神经吞噬症和小胶质结节。

我们记录了一名 73 岁男性在相对轻微的 SARS-CoV2 感染情况下死于急性小脑出血的神经病理学发现。患者突然出现头痛、恶心和呕吐，入院当天立即意识丧失。紧急医疗服务发现他在家中严重缺氧，患者在送往急诊室的途中心脏骤停。经过17分钟的复苏，急救队实现了自主循环恢复。胸片显示双侧模糊不清；鼻咽拭子上 SARS-CoV-2 的实时 PCR 呈阳性。头部计算机断层扫描显示右侧小脑大量出血，伴有扁桃体突出和脑室内出血。介绍后一天，他转为舒适护理，在姑息性拔管后不久死亡。死后 3 小时尸检显示小脑出血和背侧脑桥和延髓急性梗塞。值得注意的是，在下橄榄双侧和小脑齿状核中存在多灶性小胶质结节和神经吞噬症。迄今为止，尚未在 SARS-CoV-2 感染的背景下报道这一系列发现。