Coronavirus SARS-CoV-2 vaccine: cerebral vein thrombosis (CVT)

Evidence-based neurology checklist on coronavirus sars-cov-2 vaccine: cerebral vein thrombosis (cvt): Pathology This is usually caused by vaccine-induced immune thrombotic thrombocytopaenia (VITT) There is triggered by the binding of adenoviral DNA with platelet factor 4 (PF4) This leads to the…

Pathology

  • This is usually caused by vaccine-induced immune thrombotic thrombocytopaenia (VITT)
  • There is triggered by the binding of adenoviral DNA with platelet factor 4 (PF4)
  • This leads to the production of anti PF4 antibodies
  • About 25% of cases however do not have VITT
  • Those with VITT are younger and more likely to have multiple vein involvement

Epidemiological features

Clinical features

Haematological investigations

Brain imaging

Treatment: anticoagulation

Treatment: immunomodulation

Prognosis

Synonym of VITT

Acronym

References

  1. Furie KL, Cushman M, Elkind MSV, et al. Diagnosis and management of cerebral venous sinus thrombosis with vaccine-induced immune thrombotic thrombocytopenia. Stroke 2021; 52:2478-2482. 
  2. Sánchez van Kammen M, Aguiar de Sousa D, Poli S, Cordonnier C, et al. Characteristics and outcomes of patients with cerebral venous sinus thrombosis in SARS-CoV-2 vaccine-induced immune thrombotic thrombocytopenia. JAMA Neurol 2021 (Online ahead of print).
  3. Sharifian-Dorche M, Bahmanyar M, Sharifian-Dorche A, Mohammadi P, Nomovi M, Mowla A. Vaccine-induced immune thrombotic thrombocytopenia and cerebral venous sinus thrombosis post COVID-19 vaccination; a systematic review. J Neurol Sci 2021; 428:117607.
  4. Thakur KT, Tamborska A, Wood GK, et al. Clinical review of cerebral venous thrombosis in the context of COVID-19 vaccinations: evaluation, management, and scientific questions. J Neurol Sci 2021; 427:117532.
  5. Perry RJ, Tamborska A, Singh B, et al. Cerebral venous thrombosis after vaccination against COVID-19 in the UK: a multicentre cohort study. Lancet 2021; 398:1147-1156. 
  6. And 10 more. Subscribe to see the full list

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