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01-03-2022 | Stroke | Brief Communication

Arterial intracranial thrombosis as the first manifestation of vaccine-induced immune thrombotic thrombocytopenia (VITT): a case report

Authors: Michelangelo Mancuso, Dario Luca Lauretti, Nadia Cecconi, Massimo Santini, Valentina Lami, Giovanni Orlandi, Sergio Casagli, Antonella Ghetta, Gaetano Liberti, Benini Maria Elena, Gabriele Siciliano, Mirco Cosottini

Published in: Neurological Sciences | Issue 3/2022

Abstract

Objective

We describe a severe case of vaccine-induced immune thrombotic thrombocytopenia (VITT) after the first dose of the ChAdOx1 nCoV-19 vaccine leading to massive ischemic stroke.

Methods

A 42-year-old woman developed acute left hemiparesis (NIHSS 12) 9 days after the first vaccine dose.

Results

The blood tests revealed low platelets (70 10³/μL) and severe increment of D-dimer (70,745 ng/mL FEU). Brain non-contrast computed tomography and multiphasic CT angiography demonstrated a right middle cerebral artery occlusion. The patient was treated with primary thrombectomy, steroids, immunoglobulin, and fondaparinux. Despite the treatment, the neurological status deteriorated and underwent decompressive hemicraniectomy. She was transferred to the rehab’s unit 52 days after the onset.

Discussion

Healthcare providers should be aware of the possibility of ischemic stroke as a manifestation of VITT. Awareness on this very rare and possibly fatal complication should be reinforced on both the vaccine recipients and general practitioners.

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Title: Arterial intracranial thrombosis as the first manifestation of vaccine-induced immune thrombotic thrombocytopenia (VITT): a case report
Authors: Michelangelo Mancuso
Dario Luca Lauretti
Nadia Cecconi
Massimo Santini
Valentina Lami
Giovanni Orlandi
Sergio Casagli
Antonella Ghetta
Gaetano Liberti
Benini Maria Elena
Gabriele Siciliano
Mirco Cosottini
Publication date: 01-03-2022
Publisher: Springer International Publishing
Keywords: Stroke
Thrombocytopenia
CT Angiography
COVID-19
Thrombosis
Thrombectomy
Fondaparinux
Published in: Neurological Sciences / Issue 3/2022
Print ISSN: 1590-1874
Electronic ISSN: 1590-3478
DOI: https://doi.org/10.1007/s10072-021-05800-3

At a glance: The STEP trials

Springer Medicine

Arterial intracranial thrombosis as the first manifestation of vaccine-induced immune thrombotic thrombocytopenia (VITT): a case report

Abstract

Objective

Methods

Results

Discussion

At a glance: The STEP trials

Springer Medicine

Abstract

Objective

Methods

Results

Discussion

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