scholarly journals Syndrome of cerebral venous sinus thrombosis and thrombocytopenia after vaccination for COVID-19

2021 ◽  
Author(s):  
Babak Soleimani ◽  
Sanchit Turaga ◽  
Dalia Khan ◽  
Claire Davies ◽  
Yaw Duodu ◽  
...  
Keyword(s):  
Sinus Thrombosis ◽  
Case Series ◽  
Multidisciplinary Care ◽  
Intravenous Immunoglobulins ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus ◽  
Laboratory Findings ◽  
Platelet Factor ◽  
Venous Sinus Thrombosis ◽  
Decompressive Hemicraniectomy

Abstract Experience in the management of COVID-19 vaccine induced thrombosis and thrombocytopenia is currently lacking. In this case series we report the presentation and our experience in the management of cerebral venous sinus thrombosis and thrombocytopenia post ChAdOx1 nCoV-19 vaccination. Two of the three cases had confirmed anti-platelet factor 4 antibodies and extracranial thrombosis. In all the cases, plasma exchange, intravenous immunoglobulins and steroids normalised the platelet count and intravenous argatroban was used for initial anticoagulation. Two cases received a platelet transfusion and required decompressive hemicraniectomy due to raised intracranial pressure, secondary to cerebral oedema and haemorrhage. Prompt assessment of a new persistent headache occurring between 5 and 28 days of receiving the ChAdOx1 nCoV-19 vaccine is warranted irrespective of age. In cases with venous thrombosis on imaging or abnormal laboratory findings (thrombocytopenia, abnormal clotting or elevated D-dimer), urgent transfer to a tertiary centre is recommended for multidisciplinary care and prevention of life-threatening complications from this rare syndrome.

scholarly journals Cerebral venous sinus thrombosis after ChAdOx1 nCov-19 vaccination with a misleading first cerebral MRI scan

2021 ◽  
pp. svn-2021-001095
Author(s):  
Benno Ikenberg ◽  
Antonia Franziska Demleitner ◽  
Thomas Thiele ◽  
Benedikt Wiestler ◽  
Katharina Götze ◽  
...  
Keyword(s):  
Sinus Thrombosis ◽  
Intravenous Immunoglobulins ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus ◽  
Pathological Findings ◽  
Mri Scan ◽  
Platelet Factor ◽  
Venous Sinus Thrombosis ◽  
Activation Assay ◽  
Cerebral Mri

Vaccine-induced immune thrombotic thrombocytopenia (VITT) and cerebral venous sinus thrombosis (CVST) have been recently described as rare complications following vaccination against SARS-CoV-2 with vector vaccines. We report a case of a young woman who presented with VITT and cerebral CVST 7 days following vaccination with ChAdOx1 nCov-19 (AstraZeneca). While the initial MRI was considered void of pathological findings, MRI 3 days later revealed extensive CVST of the transversal and sigmoidal sinus with intracerebral haemorrhage. Diagnostic tests including a platelet-factor-4-induced platelet activation assay confirmed the diagnosis of VITT. Treatment with intravenous immunoglobulins and argatroban resulted in a normalisation of platelet counts and remission of CVST.

scholarly journals Cerebral venous sinus thrombosis complicated by subdural hematomas: Case series and literature review

2013 ◽  
Vol 4 (1) ◽  
pp. 85 ◽  
Author(s):  
PaulT Akins ◽  
YekaterinaK Axelrod ◽  
Cheng Ji ◽  
JeremyN Ciporen ◽  
SyedT Arshad ◽  
...  
Keyword(s):  
Literature Review ◽  
Sinus Thrombosis ◽  
Case Series ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus ◽  
Venous Sinus Thrombosis ◽  
Subdural Hematomas

Cerebral venous sinus thrombosis: a case series including thrombolysis

2009 ◽  
Vol 94 (10) ◽  
pp. 790-794 ◽  
Author(s):  
A A Mallick ◽  
P M Sharples ◽  
S E Calvert ◽  
R W A Jones ◽  
M Leary ◽  
...  
Keyword(s):  
Sinus Thrombosis ◽  
Case Series ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus ◽  
Venous Sinus Thrombosis

scholarly journals Cerebral Venous Sinus Thrombosis Associated with COVID-19: A Case Series and Literature Review

2020 ◽  
Author(s):  
Vahid Reza Ostovan ◽  
Razieh Foroughi ◽  
Mahtab Rostami ◽  
Mostafa Almasi-Dooghaee ◽  
Manouchehr Esmaili ◽  
...  
Keyword(s):  
Sinus Thrombosis ◽  
Clinical Manifestations ◽  
Case Series ◽  
Cerebral Venous Sinus Thrombosis ◽  
Hemorrhagic Transformation ◽  
Venous Sinus ◽  
Teaching Hospitals ◽  
Venous Sinus Thrombosis ◽  
North West ◽  
Confirmatory Tests

Abstract Background: Since the COVID-19 pandemic, several cases of cerebral venous sinus thrombosis (CVST) have been reported in SARS-CoV-2 infected individuals. This study provides a series of patients with CVST and SARS-CoV-2 infection.Methods: Consecutive patients with documented SARS-CoV-2 infection, as well as clinical and radiological characteristics of CVST, were reported from three teaching hospitals in the South West, North West, and the center of Iran from June to July 2020. We also searched the abstract archives until the end of August 2020 and gathered 28 reported cases. The diagnostic criteria for SARS-CoV-2 infection were determined according to SARS-CoV-2 detection in oropharyngeal or nasopharyngeal samples in clinically suspected patients. Demographics, main COVID-19 symptoms, confirmatory tests for SARS-CoV-2 infection diagnosis, the interval between the diagnosis of SARS-CoV-2 infection and CVST, clinical and radiological features of CVST, therapeutic strategies, CVST outcomes, rate of hemorrhagic transformation, and mortality rate were investigated.Results: Six patients (aged 31 to 62 years old) with confirmed CVST and SARS-CoV-2 infection were admitted to our centers. Four patients had no respiratory symptoms of SARS-CoV-2 infection. Five out of six patients developed the clinical manifestations of CVST and SARS-CoV-2 infection simultaneously. Three patients had known predisposing factors for CVST. Despite receiving CVST and SARS-CoV-2 infection treatments, four out of six patients passed away.Conclusions: The role of SARS-CoV-2 as a “cause” versus an “additive contributor” remains to be elucidated. Practitioners should be aware of the possibility of CVST in SARS-CoV-2 infection.

scholarly journals Cerebral venous sinus thrombosis on MRI: A case series analysis

2014 ◽  
Vol 7 (3) ◽  
pp. 296 ◽  
Author(s):  
SanjayM Khaladkar ◽  
DhavalK Thakkar ◽  
DollyK Thakkar ◽  
Harshawardhan Shrotri ◽  
VilasM Kulkarni
Keyword(s):  
Sinus Thrombosis ◽  
Case Series ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus ◽  
Venous Sinus Thrombosis ◽  
Series Analysis

Cerebral Venous Sinus Thrombosis due to Thrombosis with Thrombocytopenia Syndrome Following Ad26.COV2.S: A First Real-World Case Report of a Male Subject

2021 ◽  
pp. 194187442110550
Author(s):  
Samia Asif ◽  
Meghana Kesireddy ◽  
Scott A. Koepsell ◽  
Marco A. Gonzalez-Castellon ◽  
Krishna Gundabolu ◽  
...  
Keyword(s):  
Sinus Thrombosis ◽  
Young Male ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus ◽  
Platelet Factor ◽  
Venous Sinus Thrombosis ◽  
Vein Thrombosis ◽  
First Case ◽  
Control And Prevention ◽  
Underlying Pathophysiology

Thrombosis with Thrombocytopenia Syndrome (TTS) or Vaccine-induced Immune Thrombotic Thrombocytopenia (VITT) had been reported in patients receiving the Ad26.COV2.S vaccination (Johnson & Johnson [J&J]/Janssen) vaccine. They frequently presented with cerebral venous sinus thrombosis (CVST), but venous or arterial thrombosis at other locations can be present. The majority of those affected are younger adult females. Therefore, after a brief pause from April 13–23, 2021, the Centers for Disease Control and Prevention (CDC) and the U.S. Food and Drug Administration (FDA) recommended caution in using this vaccine in females under 50 years. Based on the reported 28 cases of TTS after this vaccination (data till April 21, 2021) by CDC, 22 were females (78%), and 6 were male. None of those males had CVST but had thrombosis at other locations. We report the first case of a young male with TTS and CVST following Ad26.COV2.S vaccine presented with severe headache and diagnosed with acute right transverse and sigmoid cerebral venous sinus thrombosis, multiple right-sided pulmonary emboli, and right hepatic vein thrombosis. He was treated with parenteral anticoagulation with argatroban and intravenous immune globulin with the improvement of his symptoms. A heparin-induced thrombocytopenia with thrombosis (HITT) like syndrome caused by the genesis of a platelet-activating autoantibody against platelet factor 4 (PF4) triggered by adenoviral vector-based COVID-19 vaccinations is understood to be the underlying pathophysiology. TTS with CVST should be considered when patients present with headaches, stroke-like neurological symptoms, thrombocytopenia, and symptom onset 6–15 days after Ad26.COV2.S vaccination.

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