scholarly journals Cerebral Vein Thrombosis With Vaccine-Induced Immune Thrombotic Thrombocytopenia

Stroke ◽  
2021 ◽  
Author(s):  
James E. Siegler ◽  
Piers Klein ◽  
Shadi Yaghi ◽  
Nicholas Vigilante ◽  
Mohamad Abdalkader ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Young Women ◽  
Observational Studies ◽  
Acute Treatment ◽  
Early Recognition ◽  
Cerebral Vein ◽  
Human Coronavirus ◽  
Cerebral Vein Thrombosis ◽  
Platelet Factor ◽  
Vein Thrombosis

In the spring of 2021, reports of rare and unusual venous thrombosis in association with the ChAdOx1 and Ad26.COV2.S adenovirus-based coronavirus vaccines led to a brief suspension of their use by several countries. Thromboses in the cerebral and splanchnic veins among patients vaccinated in the preceding 4 weeks were described in 17 patients out of 7.98 million recipients of the Ad26.COV2.S vaccine (with 3 fatalities related to cerebral vein thrombosis) and 169 cases of cerebral vein thrombosis among 35 million ChAdOx1 recipients. Events were associated with thrombocytopenia and anti-PF4 (antibodies directed against platelet factor 4), leading to the designation vaccine-induced immune thrombotic thrombocytopenia. Unlike the related heparin-induced thrombotic thrombocytopenia, with an estimated incidence of <1:1000 patients treated with heparin, and a mortality rate of 25%, vaccine-induced immune thrombotic thrombocytopenia has been reported in 1:150 000 ChAdOx1 recipients and 1:470 000 Ad26.COV.2 recipients, with a reported mortality rate of 20% to 30%. Early recognition of this complication should prompt testing for anti-PF4 antibodies and acute treatment targeting the autoimmune and prothrombotic processes. Intravenous immunoglobulin (1 g/kg for 2 days), consideration of plasma exchange, and nonheparin anticoagulation (argatroban, fondaparinux) are recommended. In cases of cerebral vein thrombosis, one should monitor for and treat the known complications of venous congestion as they would in patients without vaccine-induced immune thrombotic thrombocytopenia. Now that the Ad26.COV2.S has been reapproved for use in several countries, it remains a critical component of our pharmacological armamentarium in stopping the spread of the human coronavirus and should be strongly recommended to patients. At this time, the patient and community-level benefits of these two adenoviral vaccines vastly outweigh the rare but serious risks of vaccination. Due to the relatively low risk of severe coronavirus disease 2019 (COVID-19) in young women (<50 years), it is reasonable to recommend an alternative vaccine if one is available. Ongoing postmarketing observational studies are important for tracking new vaccine-induced immune thrombotic thrombocytopenia cases and other rare side effects of these emergent interventions.

Natural history of cerebral vein thrombosis: a systematic review

Blood ◽  
2006 ◽  
Vol 108 (4) ◽  
pp. 1129-1134 ◽  
Author(s):  
Francesco Dentali ◽  
Monica Gianni ◽  
Mark A. Crowther ◽  
Walter Ageno
Keyword(s):  
Mortality Rate ◽  
Natural History ◽  
First Episode ◽  
Cerebral Vein ◽  
Cerebral Vein Thrombosis ◽  
Vein Thrombosis ◽  
Risk Of Death ◽  
Hospitalization Period

Abstract Cerebral vein thrombosis (CVT) has been considered, until a few years ago, an uncommon disease with significant long-term morbidity and high mortality rate. New noninvasive diagnostic techniques have increased the frequency with which this disease is diagnosed; despite this, there continues to be little data on its natural history. The objectives of this study were to evaluate the mortality rate, the rate of disability at long-term follow-up, and the incidence of recurrence after a first episode of CVT; to determine clinical and radiologic predictors of death and dependence; and to identify possible risk factors for recurrence. (Data source: MEDLINE and EMBASE databases, reference lists of selected articles and authors' libraries.) Nineteen studies were identified. Mortality rate during peri-hospitalization period is 5.6% (range, 0%-15.2%) and 9.4% (range, 0%-39%) at the end of follow-up period. Eighty-eight percent of surviving patients recover completely or have only a mild functional or cognitive deficit. Two thirds of patients with CVT recanalized within the first few months after presentation, and 2.8% (range, 0%-11.7%) had objectively confirmed recurrence. We conclude that patients with CVT have a low risk of death and that most patients have a good long-term prognosis.

scholarly journals Deep cerebral vein thrombosis due to iron deficiency anemia: A case report

2016 ◽  
Vol 3 (3) ◽  
pp. 4
Author(s):  
Nao Nishida ◽  
Yoshimasa Sueda ◽  
Tomomi Kanbara ◽  
Takashi Kurashige ◽  
Tsuyoshi Torii
Keyword(s):  
Case Report ◽  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Young Women ◽  
Deficiency Anemia ◽  
Central Vein ◽  
Cerebral Vein ◽  
Common Condition ◽  
Cerebral Vein Thrombosis ◽  
Vein Thrombosis

We report on a 28-year-old woman who developed deep cerebral vein thrombosis (CVT) associated with iron deficiency anemia (IDA). Activation of platelet function by IDA may lead to CVT and sometimes results in death when a deep central vein is affected. While IDA is a common condition, especially among young women, proper management of IDA is needed to prevent severe venous thrombosis.

Oral Contraceptives Are a Risk Factor for Cerebral Vein Thrombosis

1996 ◽  
Vol 76 (03) ◽  
pp. 477-478 ◽  
Author(s):  
I Martinelli ◽  
F R Rosendaal ◽  
J P Vandenbroucke ◽  
P M Mannucci
Keyword(s):  
Risk Factor ◽  
Oral Contraceptives ◽  
Cerebral Vein ◽  
Cerebral Vein Thrombosis ◽  
Vein Thrombosis

scholarly journals Convexity subarachnoid hemorrhage: clinical features and etiology of an Argentinian cohort

2017 ◽  
Vol 75 (12) ◽  
pp. 858-861 ◽  
Author(s):  
Aníbal Chertcoff ◽  
Lucrecia Bandeo ◽  
Fátima Pantiu ◽  
Luciana León Cejas ◽  
Sol Pacha ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Clinical Features ◽  
Wide Spectrum ◽  
Amyloid Angiopathy ◽  
Cerebral Vein ◽  
Cerebral Vein Thrombosis ◽  
Vein Thrombosis ◽  
Cerebral Vasoconstriction ◽  
Subarachnoid Bleeding ◽  
Cerebral Amyloid

ABSTRACT Nontraumatic convexity subarachnoid hemorrhage is an increasingly recognized subtype of subarachnoid bleeding. Objective: Our aim was to describe the etiology and clinical features of a cohort of patients with convexity subarachnoid hemorrhage. Methods: We retrospectively analyzed all cases of convexity subarachnoid hemorrhage admitted to our hospital between January 2012 and April 2017. Demographic features, clinical characteristics, complementary investigations, etiology and mortality were assessed. Twenty patients (65% females) were identified. Mean age: 53 years (range, 15-86 years). Results: Symptoms on admission: headache (65%), sensory and/or motor symptoms (50%) and seizures (35%). Commonest causes: cerebral vein thrombosis (20%), reversible cerebral vasoconstriction syndrome (20%) and cerebral amyloid angiopathy (20%). Two patients died. Conclusion: Convexity subarachnoid hemorrhage may be related to a wide spectrum of etiologies. In our patients, an increased prevalence of cerebral vein thrombosis was observed. Mortality was low and not related to the bleeding itself.

scholarly journals Cerebral Vein Thrombosis in the Antiphospholipid Syndrome: Analysis of a Series of 27 Patients and Review of the Literature

2021 ◽  
Vol 11 (12) ◽  
pp. 1641
Author(s):  
Alba Jerez-Lienas ◽  
Alexis Mathian ◽  
Jenifer Aboab ◽  
Isabelle Crassard ◽  
Miguel Hie ◽  
...  
Keyword(s):  
Antiphospholipid Syndrome ◽  
Medical Records ◽  
Case Reports ◽  
Case Series ◽  
Autoimmune Disorder ◽  
Point Of View ◽  
Cerebral Vein ◽  
Review Of The Literature ◽  
Cerebral Vein Thrombosis ◽  
Vein Thrombosis

(1) Background: The Antiphospholipid Syndrome (APS) is a systemic autoimmune disorder characterized by arterial and/or venous thrombosis, pregnancy morbidity and raised titers of antiphospholipid antibodies. Cerebral vein thrombosis (CVT) is a rare form of cerebrovascular accident and an uncommon APS manifestation; the information in the literature about this feature consists of case reports and small case series. Our purpose is to describe the particular characteristics of CVT when occurs as part of the APS and compare our series with the patients published in the literature. (2) Methods: We conducted a retrospective observational study collecting data from medical records in three referral centers for APS and CVT, and a systematic review of the literature for CVT cases in APS patients. (3) Results: Twenty-seven APS patients with CVT were identified in our medical records, the majority of them diagnosed as primary APS and with the CVT being the first manifestation of the disease; additional risk factors for thrombosis were identified. The review of the literature yielded 86 cases, with similar characteristics as those of our retrospective series. (4) Conclusions: To our knowledge, our study is the largest CVT series in APS patients published to date, providing a unique point of view in this rare thrombotic manifestation.

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