You are here

Article Text

Article menu

Download PDFPDF

Case report
Cerebral venous sinus thrombosis after ChAdOx1 nCov-19 vaccination with a misleading first cerebral MRI scan
  1. Benno Ikenberg1,
  2. Antonia Franziska Demleitner1,
  3. Thomas Thiele2,
  4. Benedikt Wiestler3,
  5. Katharina Götze4,
  6. Georg Mößmer5,
  7. Paul Lingor1
  1. 1 Department of Neurology, Klinikum rechts der Isar der Technischen Universität München, Munchen, Germany
  2. 2 Institut für Immunologie und Transfusionsmedizin, Universitätsmedizin Greifswald, Greifswald, Germany
  3. 3 Department of Diagnostic und Interventional Neuroradiology, Klinikum rechts der Isar der Technischen Universität München, Munchen, Germany
  4. 4 Department of Medicine III, Klinikum rechts der Isar der Technischen Universität München, Munchen, Germany
  5. 5 Institute for Clinical Chemistry and Pathobiochemistry, Klinikum rechts der Isar der Technischen Universität München, Munchen, Germany
  1. Correspondence to Dr Benno Ikenberg; benno.ikenberg{at}tum.de

Abstract

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.

  • COVID-19
  • haemorrhage
  • MRI
  • blood platelets
  • complication
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (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, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/svn-2021-001095

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text

    Footnotes

    • BI and AFD contributed equally.

    • Contributors Treating neurologists: BI, AFD and PL; MRI analysis and interpretation: BW; laboratory tests and interpretation: TT, KG and GM; first draft: BI; supervision: PL. All authors revised and approved the final version of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; internally peer reviewed.