Relative Brain Perfusion Differences in a Patient With Persistent Neurocognitive and Vestibular Symptoms Associated With Post-COVID-19 Condition: A Case Report

Post-COVID-19 condition may present with persistent subjective cognitive and vestibular symptoms despite unrevealing conventional diagnostic evaluation. We report the case of a 67-year-old woman who developed persistent subjective cognitive symptoms ("brain fog"), dizziness, vertigo, and imbalance following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. After an unrevealing conventional diagnostic evaluation, brain perfusion single-photon emission computed tomography (SPECT), obtained as part of the clinical evaluation, demonstrated a nonspecific mixed pattern of relative cortical and subcortical perfusion abnormalities. An individualized management plan was subsequently implemented, and during approximately five months of follow-up, the patient reported gradual improvement in subjective cognitive symptoms, balance, and daily functioning; however, because multiple interventions were introduced concurrently, the contribution of any individual intervention cannot be determined. This case describes a nonspecific pattern of relative brain perfusion abnormalities in a patient with post-COVID-19 condition. The relationship between these imaging findings and the patient's clinical symptoms remains uncertain, and this single observation does not establish the diagnostic or clinical utility of brain perfusion SPECT.