Context: This case report describes a patient with bilateral dissection of the carotid and vertebral arteries after being immunized by the Astrazeneca vaccine against COVID-19. Case report: AVC, female, 55 years old, health professional, without previous illness, received ChAdOx1 nCov-19 AstraZeneca vaccine and evolved after one day with flu-like symptoms, headache, odynophagia, fever, myalgia for 5 days. On the 7th day, she sought hospital service complaining of sudden headache, and numbness in the left upper limb. A non-reactive Sars-Cov-2 RT-PCR test was performed. The patient was released after clinical improvement. She returned after 8 days, being diagnosed with migraine and was treated with sintomatic drugs. After more 7 days, during the neurologist appointment, she reported daily headaches of varying intensity and episodes of unverified fever, with no findings on physical examination. Laboratory tests, brain resonance with cranial and cervical angioresonance, which showed findings of bilateral carotid dissection, involving the supra-bulbar segments of both internal carotid arteries, notably in the right internal carotid artery, as well as degrees of dissection of both vertebral arteries. On admission, antiplatelet aggregation was chosen, with the patient showing good evolution and being discharged after 4 days for outpatient follow-up. Conclusion: The patient has no evident risk factor for arterial dissection. In addition, the post-vaccine adverse reaction and the temporal gap between the application of the vaccine and the development of multiple arterial dissections drew attention. A possible link between the patient’s immune response and vascular endothelial inflammatory reaction is suggested, resulting in multiple arterial dissections.
Simultaneous Bilateral Stenosis of the Vertebral Arteries Treated by Unilateral Decompression: A Case Report