scholarly journals A Rare Case of Cerebral Venous Thrombosis and Disseminated Intravascular Coagulation Temporally Associated to the COVID-19 Vaccine Administration

2021 ◽  
Vol 11 (4) ◽  
pp. 285
Author(s):  
Vincenzo D’Agostino ◽  
Ferdinando Caranci ◽  
Alberto Negro ◽  
Valeria Piscitelli ◽  
Bernardino Tuccillo ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Disseminated Intravascular Coagulation ◽  
Cerebral Venous Thrombosis ◽  
Blood Platelets ◽  
Brain Magnetic Resonance Imaging ◽  
Genetic Alterations ◽  
Vaccine Administration ◽  
Intravascular Coagulation ◽  
Angio Ct ◽  
The Right

Globally, at the time of writing (20 March 2021), 121.759.109 confirmed COVID-19 cases have been reported to the WHO, including 2.690.731 deaths. Globally, on 18 March 2021, a total of 364.184.603 vaccine doses have been administered. In Italy, 3.306.711 confirmed COVID-19 cases with 103.855 deaths have been reported to WHO. In Italy, on 9 March 2021, a total of 6.634.450 vaccine doses have been administered. On 15 March 2021, Italian Medicines Agency (AIFA) decided to temporarily suspend the use of the AstraZeneca COVID-19 vaccine throughout the country as a precaution, pending the rulings of the European Medicines Agency (EMA). This decision was taken in line with similar measures adopted by other European countries due to the death of vaccinated people. On 18 March 2021, EMA’s safety committee concluded its preliminary review about thromboembolic events in people vaccinated with COVID-19 Vaccine AstraZeneca at its extraordinary meeting, confirming the benefits of the vaccine continue to outweigh the risk of side effects, however, the vaccine may be associated with very rare cases of blood clots associated with thrombocytopenia, i.e., low levels of blood platelets with or without bleeding, including rare cases of cerebral venous thrombosis (CVT). We report the case of a 54-year-old woman who developed disseminated intravascular coagulation (DIC) with multi-district thrombosis 12 days after the AstraZeneca COVID-19 vaccine administration. A brain computed tomography (CT) scan showed multiple subacute intra-axial hemorrhages in atypical locations, including the right frontal and the temporal lobes. A plain old balloon angioplasty (POBA) of the right coronary artery was performed, without stent implantation, with restoration of distal flow, but with persistence of extensive thrombosis of the vessel. A successive thorax angio-CT added the findings of multiple contrast filling defects with multi-vessel involvement: at the level of the left upper lobe segmental branches, of left interlobar artery, of the right middle lobe segmental branches and of the right interlobar artery. A brain magnetic resonance imaging (MRI) in the same day showed the presence of an acute basilar thrombosis associated with the superior sagittal sinus thrombosis. An abdomen angio-CT showed filling defects at the level of left portal branch and at the level of right suprahepatic vein. Bilaterally, it was adrenal hemorrhage and blood in the pelvis. An evaluation of coagulation factors did not show genetic alterations so as the nasopharyngeal swab ruled out a COVID-19 infection. The patient died after 5 days of hospitalization in intensive care.

Cerebral Venous Thrombosis After Epidural Blood Patch: Coincidence or Causal Relation? A Case Report and Review of the Literature

Cephalalgia ◽  
2008 ◽  
Vol 28 (7) ◽  
pp. 769-773 ◽  
Author(s):  
M Kueper ◽  
SL Goericke ◽  
O Kastrup
Keyword(s):  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
Epidural Blood Patch ◽  
Causal Relation ◽  
Common Symptom ◽  
Factor V ◽  
Review Of The Literature ◽  
Post Dural Puncture Headache ◽  
Blood Patch ◽  
The Right

We report on a female patient who developed post-dural puncture headache (PDPH) after epidural analgesia for delivery. Treatment with epidural blood patch led to complete headache remission and the patient was discharged. Two days later the patient was readmitted with hemihypaesthesia and mild hemiparesis of the right side. Magnetic resonance imaging showed a small left parietal cortical haemorrhage probably following cerebral venous thrombosis (CVT). Coagulation screening detected heterozygous Factor V mutation. Headache is a common symptom of PDPH and CVT. Review of the literature revealed five patients in puerperal state, who developed CVT in close temporal relationship after blood patch treatment for PDPH. Change of headache character with loss of postural influence was reported frequently before diagnosis of CVT was confirmed. These findings may indicate a causal relationship.

A Study of the Metabolism of Fibrinogen after Surgical Operations

1971 ◽  
Vol 41 (2) ◽  
pp. 141-152 ◽  
Author(s):  
J. A. Hickman
Keyword(s):  
Venous Thrombosis ◽  
Disseminated Intravascular Coagulation ◽  
Half Life ◽  
Plasma Fibrinogen ◽  
Intravascular Coagulation ◽  
Plasma Loss ◽  
The Mean ◽  
Chronic Disorders ◽  
Contrast Group ◽  
Surgical Operations

1. The turnover of fibrinogen was studied in twenty-eight patients after moderate and major surgical operations and in a contrast group of thirteen patients suffering from miscellaneous chronic disorders. 2. After operation the mean biological half-life of fibrinogen was 60.1 h (SD 16.4) and the mean plasma loss of fibrinogen was 40.1% (SD 12.6) of the intravascular fibrinogen pool each 24 h. In the contrast group, respective values of 96.2 h (SD 13.1) and 22.5% (SD 2.0) were obtained, which are in agreement with published values for the normal catabolism of fibrinogen. 3. When the post-operative increase in the plasma fibrinogen pool was taken into account, a massive increase in the absolute plasma loss of fibrinogen was observed with values approaching those reported for albumin turnover. 4. Possible sites of loss and the relevance of this investigation to the detection of disseminated intravascular coagulation and venous thrombosis are discussed.

scholarly journals Dulaglutide-induced cerebral venous thrombosis in a patient with type 2 diabetes mellitus

2018 ◽  
pp. bcr-2018-226346 ◽  
Author(s):  
Rajesh Rajput ◽  
Vaibhav Pathak ◽  
Pawan Kumar Yadav ◽  
Sanat Mishra
Keyword(s):  
Diabetes Mellitus ◽  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
Sinus Thrombosis ◽  
Transverse Sinus ◽  
Nausea And Vomiting ◽  
Acute Infarct ◽  
Patients With Diabetes ◽  
The Right

Though patients with diabetes mellitus are at a high risk of atherothrombotic events, every such event should not be attributed to the disease itself. We present a case of a patient with diabetes with headache and blurring of vision for 3 days. Brain imaging revealed right transverse sinus thrombosis and acute infarct of the right posterior parieto-occipital region, predominantly in the posterior cortical watershed zone. The patient was on subcutaneous dulaglutide for 3 weeks and was having nausea and vomiting. Various causes of cerebral venous thrombosis were ruled out with appropriate laboratory investigations. Finally, cerebral venous thrombosis was attributed to dulaglutide-induced nausea and vomiting which led to severe dehydration.

Anticoagulant Properties of Rabbit Lungs in Tissue Thromboplastin-induced Intravascular Coagulation

1997 ◽  
Vol 77 (04) ◽  
pp. 679-684 ◽  
Author(s):  
Henrik Vad ◽  
Tove F Tvedskov ◽  
Knud B Hansen ◽  
Ole K Albrechtsen ◽  
Jørgen Jespersen ◽  
...  
Keyword(s):  
Prothrombin Time ◽  
Right Atrium ◽  
Blood Platelets ◽  
Rabbit Brain ◽  
Intravascular Coagulation ◽  
Common Trend ◽  
Blood Ph ◽  
First Pass ◽  
Tissue Thromboplastin ◽  
The Right

SummaryThis study was conducted in order to examine possible anticoagulant properties of the lungs during tissue thromboplastin-induced intravascular coagulation. Rabbit brain tissue thromboplastin (n = 17) or saline (n = 6 + 3) was infused above the right atrium (n = 11 + 3) of the heart or in the arcus aorta (n = 6) for a period of 120 min in non-pregnant New Zealand rabbits. Rabbits infused with tissue thromboplastin responded with significantly (p <0.05) more excessive changes in a number of haemodynamic variables (heart rate, paO2> paCO2, blood pH etc.) compared with rabbits infused with saline.Similarly, the prothrombin time (p <0.05) and the activated partial thromboplastin time (p <0.05) were significantly more prolonged in rabbits receiving tissue thromboplastin compared with control animals. Also the concentration of blood platelets (p<0.05), plasma fibrinogen (p <0.05), antithrombin (p <0.05), and protein C (p <0.05) decreased significantly in thromboplastin-treated animals compared with control animals. In all these haemostatic variables there was a common trend that animals infused with tissue thromboplastin in the arcus aorta responded more excessively than animals infused in the right atrium of the heart, and these deviations were statistically significant for fibrinogen (p <0.05) and prothrombin time (p <0.05). Similarly, animals infused with tissue thromboplastin in the arcus aorta had an increased number of microthrombi in the lungs and kidneys compared with animals receiving tissue thromboplastin above the right atrium.As the lungs are the first pass organ when you infuse above the right atrium the results from this study suggest that the lungs play a key role in protecting the organism against excessive tissue thromboplastin-induced activation of coagulation.

scholarly journals Combined Hypertrophic Pachymeningitis and Cerebral Venous Thrombosis in a Case of Granulomatosis with Polyangiitis

2019 ◽  
Vol 11 (2) ◽  
pp. 252-255
Author(s):  
Tadahiro Kuribayashi ◽  
Yasuhiro Manabe ◽  
Shunya Fujiwara ◽  
Yoshio Omote ◽  
Hisashi Narai ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
Granulomatosis With Polyangiitis ◽  
Laboratory Data ◽  
Brain Magnetic Resonance Imaging ◽  
Antineutrophil Cytoplasmic Antibody ◽  
Hypertrophic Pachymeningitis ◽  
Left Frontal Lobe ◽  
Sagittal Sinus

We report a rare case of hypertrophic pachymeningitis (HP) and cerebral venous thrombosis associated with proteinase-3-antineutrophil cytoplasmic antibody (PR3-ANCA)-positive granulomatosis with polyangiitis (GPA). A 58-year-old male developed left headache after exudative otitis media. The laboratory data were positive for PR3-ANCA. Brain magnetic resonance imaging revealed bilateral paranasal sinusitis, left frontal lobe edema, and a thick dura mater with abnormal enhancement in the frontotemporal lobe. Magnetic resonance venography detected stenosis of the superior sagittal sinus. The patient was successfully treated with glucocorticoid, cyclophosphamide, and apixaban. Contrast neuroimaging should be performed for patients who present with unexplained headache, especially with middle ear and paranasal inflammation. These symptoms should be considered as GPA-related HP and cerebral venous thrombosis.

scholarly journals Tissue Factor and Extracellular Vesicles: Activation of Coagulation and Impact on Survival in Cancer

Cancers ◽  
2021 ◽  
Vol 13 (15) ◽  
pp. 3839
Author(s):  
Yohei Hisada ◽  
Nigel Mackman
Keyword(s):  
Pancreatic Cancer ◽  
At Risk ◽  
Venous Thrombosis ◽  
Cancer Patients ◽  
Tissue Factor ◽  
Extracellular Vesicles ◽  
Disseminated Intravascular Coagulation ◽  
Intravascular Coagulation ◽  
Impact On Survival ◽  
Patients At Risk

Tissue factor (TF) is a transmembrane glycoprotein that functions as a receptor for FVII/FVIIa and initiates the extrinsic coagulation pathway. Tumors and cancer cells express TF that can be released in the form of TF positive (TF+) extracellular vesicles (EVs). In this review, we summarize the studies of tumor TF and TF + EVs, and their association with activation of coagulation and survival in cancer patients. We also summarize the role of tumor-derived TF + EVs in venous thrombosis in mouse models. Levels of tumor TF and TF + EVs are associated with venous thromboembolism in pancreatic cancer patients. In addition, levels of EVTF activity are associated with disseminated intravascular coagulation in cancer patients. Furthermore, tumor-derived TF + EVs enhance venous thrombosis in mice. Tumor TF and TF + EVs are also associated with worse survival in cancer patients, particularly in pancreatic cancer patients. These studies indicate that EVTF activity could be used as a biomarker to identify pancreatic cancer patients at risk for venous thrombosis and cancer patients at risk for disseminated intravascular coagulation. EVTF activity may also be a useful prognostic biomarker in cancer patients.

Anti-MOG Antibody Syndrome and Cerebral Sinovenous Thrombosis: A Cause–Effect Hypothesis

2020 ◽  
Author(s):  
Alessandra Fontana ◽  
Filippo Greco ◽  
Pierluigi Smilari ◽  
Andrea D. Praticò ◽  
Agata Fiumara ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
Superior Sagittal Sinus ◽  
Demyelinating Diseases ◽  
Sagittal Sinus ◽  
Cerebral Sinovenous Thrombosis ◽  
Sinovenous Thrombosis ◽  
Clinical Relationship ◽  
Effect Hypothesis ◽  
The Right

AbstractCerebral venous thrombosis is an uncommon event of stroke in childhood. Its origin is multifactorial and often it manifests with nonspecific symptoms that may overlap with underlying predisposing factors. Anti–myelin oligodendrocyte glycoprotein (MOG) antibody syndrome is a group of recently recognized acquired demyelinating diseases that occur more commonly in children, usually, with a favorable outcome. The association between cerebral venous thrombosis and demyelinating syndrome has been reported but their clinical relationship is matter of debate and various hypotheses have been advanced including intravenous (IV) steroid therapy and/or the consequence of a shared inflammatory-thrombotic process. Herein, we report the case of a child with anti-MOG antibody syndromes who developed a thrombosis of the superior sagittal sinus and of the right Trolard's vein.

Disseminated Intravascular Coagulation: Clinical Spectrum and Established as well as New Diagnostic Approaches

1999 ◽  
Vol 82 (08) ◽  
pp. 706-712 ◽  
Author(s):  
Hugo ten Cate ◽  
Marcel Levi ◽  
Gert Müller-Berghaus
Keyword(s):  
Disseminated Intravascular Coagulation ◽  
Clinical Symptoms ◽  
Clinical Problem ◽  
Effective Management ◽  
Therapeutic Approaches ◽  
Intravascular Coagulation ◽  
Diagnostic Approaches ◽  
Definition Of ◽  
The Right ◽  
Underlying Diseases

IntroductionAlthough disseminated intravascular coagulation (DIC) is an “intermediary mechanism of disease”1 that has been intensively studied during the last three decades,2-4 several aspects relating to the clinical problem of DIC are still under debate. For example, a standardized definition of disseminated intravascular coagulation has not yet been agreed upon. A diagnosis can be accurately made using the facilities of a specialized laboratory, but time constraints make the diagnosis of DIC by the general laboratory difficult. Since DIC can be prevented if the right therapy is initiated early, the ability to quickly and accurately diagnose DIC and to monitor the involved dynamic processes are essential prerequisites for the effective management patients with DIC.Due to the problems associated with defining DIC, making an early diagnosis, and effectively treating the condition following diagnosis, the clinical management of DIC can be difficult. The transition from an activated hemostatic system to a well-defined state of DIC is indistinct, and the borderlines cannot easily be distinguished. In addition, different underlying diseases mediating DIC induce different clinical symptoms associated with DIC and demand different therapeutic approaches.

scholarly journals Successful Treatment of Cardiac Angiosarcoma Associated with Disseminated Intravascular Coagulation with Nab-Paclitaxel: A Case Report and Review of the Literature

2017 ◽  
Vol 10 (3) ◽  
pp. 863-870 ◽  
Author(s):  
Kazunori Honda ◽  
Masashi Ando ◽  
Keiji Sugiyama ◽  
Seiichiro Mitani ◽  
Toshiki Masuishi ◽  
...  
Keyword(s):  
Disseminated Intravascular Coagulation ◽  
Review Of The Literature ◽  
First Line ◽  
Intravascular Coagulation ◽  
Cardiac Angiosarcoma ◽  
Metastatic Lesions ◽  
First Case ◽  
Chief Complaints ◽  
The Right ◽  
Line Chemotherapy

Angiosarcoma of the heart is an uncommon soft tissue sarcoma. A few cases of disseminated intravascular coagulation (DIC) associated with angiosarcoma occurring in various organs, but not the heart, have been reported. Although taxane is commonly used in the treatment of metastatic angiosarcoma, data on the efficacy of nab-paclitaxel for angiosarcoma are limited. Here, we report probably the first case of a patient with primary cardiac angiosarcoma with coexisting DIC who was successfully treated with nab-paclitaxel. A 62-year-old female with chief complaints of nausea and shortness of breath was diagnosed as having cardiac angiosarcoma with liver metastases. Four months after the resection of her primary tumor, the hepatic metastatic lesions progressed rapidly accompanied by new metastatic lesions in the right iliac bone and signs of DIC. She received nab-paclitaxel as first-line chemotherapy. A response of stable disease was achieved after 2 treatment cycles and DIC was successfully controlled for at least 4 months. This report suggests potential utility of nab-paclitaxel for angiosarcoma complicated with DIC. We also review the literature for all cases of angiosarcoma with DIC reported so far.

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