PMID- 34327553
OWN - NLM
STAT- MEDLINE
DCOM- 20211001
LR  - 20230523
IS  - 1432-2102 (Electronic)
IS  - 0033-832X (Print)
IS  - 0033-832X (Linking)
VI  - 61
IP  - 10
DP  - 2021 Oct
TI  - [Cerebral venous sinus thrombosis after COVID-19 vaccination : Neurological and 
      radiological management].
PG  - 923-932
LID - 10.1007/s00117-021-00887-3 [doi]
AB  - BACKGROUND: Vaccine-induced cerebral venous and sinus thrombosis (VI-CVST) is 
      a rare complication in recipients of the adenovirus-vectored coronavirus disease 
      2019 (COVID-19) vaccine ChAdOx1 nCov-19 (Vaxzevria(R); AstraZeneca). OBJECTIVES: 
      Development of a diagnostic and therapeutic standard. MATERIALS AND METHODS: 
      Analysis of clinical and basic research findings, expert opinions, and experience 
      with our own cases. RESULTS: VI-CVST usually manifests on day 4-24 after 
      vaccination, mostly in individuals aged < 60 years, and women. In the majority 
      there is an immune pathogenesis caused by antibodies against platelet factor 
      4/polyanion complexes, leading to thrombotic thrombocytopenia which can result in 
      severe, sometimes fatal, course. The cardinal symptom is headache worsening 
      within days which, however, also can be of variable intensity. Other possible 
      symptoms are seizures, visual disturbance, focal neurological deficits and signs 
      of increased intracranial pressure. If VI-CVST is suspected, the determination of 
      plasma D‑dimer level, platelet count, and screening for heparin-induced 
      thrombocytopenia (HIT-2) are essential for treatment decision-making. Magnetic 
      resonance imaging (MRI) with venous MR-angiography is the neuroimaging modality 
      of choice to confirm or exclude VI-CVST. On T2* susceptibility-weighted MRI, the 
      clot in the sinuses or veins produces marked susceptibility artifacts 
      ("blooming"), which also enables the detection of isolated cortical venous 
      thromboses. MRI/MR-angiography or computed tomography (CT)/CT-angiography usually 
      allow-in combination with clinical and laboratory findings-reliable diagnosis of 
      VI-CVST. CONCLUSIONS: The clinical suspicion of VI-CVST calls for urgent 
      laboratory and neuroimaging workup. In the presence of thrombocytopenia and/or 
      pathogenic antibodies, specific medications for anticoagulation and 
      immunomodulation are recommended.
CI  - (c) 2021. Springer Medizin Verlag GmbH, ein Teil von Springer Nature.
FAU - Walter, Uwe
AU  - Walter U
AD  - Klinik und Poliklinik fur Neurologie, Universitatsmedizin Rostock, Rostock, 
      Deutschland. uwe.walter@med.uni-rostock.de.
FAU - Volmer, Erik
AU  - Volmer E
AD  - Institut fur Diagnostische und Interventionelle Radiologie, Kinder- und 
      Neuroradiologie, Universitatsmedizin Rostock, Rostock, Deutschland.
FAU - Wittstock, Matthias
AU  - Wittstock M
AD  - Klinik und Poliklinik fur Neurologie, Universitatsmedizin Rostock, Rostock, 
      Deutschland.
FAU - Storch, Alexander
AU  - Storch A
AD  - Klinik und Poliklinik fur Neurologie, Universitatsmedizin Rostock, Rostock, 
      Deutschland.
FAU - Weber, Marc-Andre
AU  - Weber MA
AD  - Institut fur Diagnostische und Interventionelle Radiologie, Kinder- und 
      Neuroradiologie, Universitatsmedizin Rostock, Rostock, Deutschland.
FAU - Grossmann, Annette
AU  - Grossmann A
AD  - Institut fur Diagnostische und Interventionelle Radiologie, Kinder- und 
      Neuroradiologie, Universitatsmedizin Rostock, Rostock, Deutschland.
LA  - ger
PT  - Journal Article
PT  - Review
TT  - Hirnvenen- und Sinusthrombose nach COVID-19-Schutzimpfung : 
      Neurologisch-radiologisches Prozedere.
DEP - 20210729
PL  - Germany
TA  - Radiologe
JT  - Der Radiologe
JID - 0401257
RN  - 0 (COVID-19 Vaccines)
RN  - B5S3K2V0G8 (ChAdOx1 nCoV-19)
SB  - IM
MH  - *COVID-19
MH  - COVID-19 Vaccines
MH  - ChAdOx1 nCoV-19
MH  - Female
MH  - Humans
MH  - SARS-CoV-2
MH  - *Sinus Thrombosis, Intracranial/chemically induced/diagnostic imaging
MH  - Vaccination
PMC - PMC8320717
OTO - NOTNLM
OT  - Intravenous immunoglobulins
OT  - Magnetic resonance imaging
OT  - SARS-CoV‑2
OT  - Vaccination complications
OT  - Vaccine-induced thrombotic thrombocytopenia
EDAT- 2021/07/31 06:00
MHDA- 2021/10/02 06:00
PMCR- 2021/07/29
CRDT- 2021/07/30 06:54
PHST- 2021/06/24 00:00 [accepted]
PHST- 2021/07/31 06:00 [pubmed]
PHST- 2021/10/02 06:00 [medline]
PHST- 2021/07/30 06:54 [entrez]
PHST- 2021/07/29 00:00 [pmc-release]
AID - 10.1007/s00117-021-00887-3 [pii]
AID - 887 [pii]
AID - 10.1007/s00117-021-00887-3 [doi]
PST - ppublish
SO  - Radiologe. 2021 Oct;61(10):923-932. doi: 10.1007/s00117-021-00887-3. Epub 2021 
      Jul 29.