Massive cerebral venous sinus thrombosis in vaccine-induced immune thrombotic thrombocytopenia after ChAdOx1 nCoV-19 serum: case report of a successful multidisciplinary approach

Neurol Sci. 2022 Mar;43(3):1499-1502. doi: 10.1007/s10072-021-05805-y. Epub 2022 Jan 10.

Abstract

We report a case of massive cerebral venous sinus thrombosis in the contest of vaccine-induced immune thrombotic thrombocytopenia that required the rapid coordination of many specialists from different departments, notably emergency, neurology, neuroradiology, hematology, and neurosurgery. The patient was rapidly treated with steroids, immunoglobulin, and fondaparinux. She underwent within 6 h after hospital admission a mechanical thrombectomy in order to allow flow restoration in cerebral venous systems. Neuroendovascular treatment in cerebral venous thrombosis related to VITT has never been described before. It can represent a complementary tool along with the other therapies and a multidisciplinary approach.

Keywords: Anticoagulation; Immunotherapy; Multimodal monitoring; Thrombectomy; VITT.

Publication types

  • Case Reports

MeSH terms

  • COVID-19 Vaccines
  • COVID-19*
  • ChAdOx1 nCoV-19
  • Female
  • Humans
  • Sinus Thrombosis, Intracranial* / chemically induced
  • Sinus Thrombosis, Intracranial* / diagnostic imaging
  • Thrombocytopenia*
  • Vaccines* / adverse effects

Substances

  • COVID-19 Vaccines
  • Vaccines
  • ChAdOx1 nCoV-19