@article{070c8317b1cd4bdf83c4b9445d018871,
title = "Clinical review of cerebral venous thrombosis in the context of COVID-19 vaccinations: Evaluation, management, and scientific questions",
abstract = "Background: Vaccine induced immune mediated thrombocytopenia or VITT, is a recent and rare phenomenon of thrombosis with thrombocytopenia, frequently including cerebral venous thromboses (CVT), that has been described following vaccination with adenovirus vaccines ChAdOx1 nCOV-19 (AstraZeneca) and Ad26.COV2·S Johnson and Johnson (Janssen/J&J). The evaluation and management of suspected cases of CVT post COVID-19 vaccination are critical skills for a broad range of healthcare providers. Methods: A collaborative comprehensive review of literature was conducted among a global group of expert neurologists and hematologists. Findings: Strategies for rapid evaluation and treatment of the CVT in the context of possible VITT exist, including inflammatory marker measurements, PF4 assays, and non-heparin anticoagulation.",
keywords = "COVID-19, Cerebral venous thrombosis, Vaccination",
author = "Thakur, {Kiran T.} and Arina Tamborska and Wood, {Greta K.} and Emily McNeill and David Roh and Akpan, {Imo J.} and Miller, {Eliza C.} and Alyssa Bautista and Jan Claassen and Kim, {Carla Y.} and Alla Guekht and Pardo, {Carlos A.} and Olajide Williams and David Garc{\'i}a-Azor{\'i}n and Kameshwar Prasad and Erich Schmutzhard and Michael, {Benedict D.} and Chou, {Sherry H.Y.} and Winkler, {Andrea S.} and Tom Solomon and Elkind, {Mitchell S.}",
note = "Funding Information: KTT is a member of the World Health Organization (WHO) working group on clinical guidance of VITT in the context of COVID-19 vaccinations, reports funding from the National Institute of Health (NIH) and Center for Disease Control and Prevention (CDC) on neurological conditions in the context of COVID-19 and COVID-19 vaccinations. AT receives funding from the National Institute for Health Research (NIHR) Academic Clinical Fellowship. DR reports funding from the National Blood Foundation, NIH, National Institute of Allergies and Infectious Disease (NIAID), Department of Defense (DOD), and Apellis Pharmaceuticals. ECM reports funding from the NIH, National Institute of Neurological Disorders and Stroke (NINDS), National Institute on Aging (NIA), and the Louis V. Gerstner, Jr. Foundation (Gerstner Scholars Program). JC reports funding from the NINDS and the McDonnell Foundation. AG reports funding from the Russian Scientific Foundation. CAP reports funding from the NIH and Bart McLean Fund for Neuroimmunology Research. DGA reports funding from the Spanish Society of Neurology, Fundaci{\'o}n Estudios de Ciencias de la Salud de Castilla y Le{\'o}n, Colegio de M{\'e}dicos de Valladolid, the International Headache Society and the WHO. BDM reports funding from the United Kingdom Research Institute / Medical Research Council (UKRI/MRC) and Wellcome. SHYC reports funding from the NIH, NINDS, National Center for Advancing Translational Sciences (NCATS), and the University of Pittsburgh School of Medicine Dean's Faculty Advancement Award. ASW reports funding from the German Federal Ministry of Education and Research and the European Union (EU). TS was Chair/Co-Chair of the United Kingdom Research and Innovation / National Institute for Health Research COVID-19 Rapid Response and Rolling Funding Initiatives (which funded the development of COVID-19 vaccines), is an Advisor to the UK COVID-19 Therapeutics Advisory Panel and a member of the UK Medicines and Healthcare Products Regulatory Agency COVID-19 Vaccines Benefit Risk Expert Working Group. TS is supported by the National Institute for Health Research (NIHR) Health Protection Research Unit in Emerging and Zoonotic Infections, NIHR Programme Grant for Applied Research, NIHR Global Health Research Group on Brain Infections, the UK Medical Research Council's Global Effort on COVID-19 Programme, and the European Union{\textquoteleft}s Horizon 2020 research and innovation program ZikaPLAN (Preparedness Latin America Network). MSE reports royalties for a chapter on COVID-19 and neurological disease in UpToDate. All other authors declare no competing interests. Funding Information: KTT is a member of the World Health Organization (WHO) working group on clinical guidance of VITT in the context of COVID-19 vaccinations, reports funding from the National Institute of Health (NIH) and Center for Disease Control and Prevention (CDC) on neurological conditions in the context of COVID-19 and COVID-19 vaccinations. AT receives funding from the National Institute for Health Research (NIHR) Academic Clinical Fellowship. DR reports funding from the National Blood Foundation, NIH, National Institute of Allergies and Infectious Disease (NIAID), Department of Defense (DOD), and Apellis Pharmaceuticals. ECM reports funding from the NIH, National Institute of Neurological Disorders and Stroke (NINDS), National Institute on Aging (NIA), and the Louis V. Gerstner, Jr. Foundation (Gerstner Scholars Program). JC reports funding from the NINDS and the McDonnell Foundation. AG reports funding from the Russian Scientific Foundation. CAP reports funding from the NIH and Bart McLean Fund for Neuroimmunology Research. DGA reports funding from the Spanish Society of Neurology, Fundaci{\'o}n Estudios de Ciencias de la Salud de Castilla y Le{\'o}n, Colegio de M{\'e}dicos de Valladolid, the International Headache Society and the WHO. BDM reports funding from the United Kingdom Research Institute / Medical Research Council (UKRI/MRC) and Wellcome. SHYC reports funding from the NIH, NINDS, National Center for Advancing Translational Sciences (NCATS), and the University of Pittsburgh School of Medicine Dean's Faculty Advancement Award. ASW reports funding from the German Federal Ministry of Education and Research and the European Union (EU). TS was Chair/Co-Chair of the United Kingdom Research and Innovation / National Institute for Health Research COVID-19 Rapid Response and Rolling Funding Initiatives (which funded the development of COVID-19 vaccines), is an Advisor to the UK COVID-19 Therapeutics Advisory Panel and a member of the UK Medicines and Healthcare Products Regulatory Agency COVID-19 Vaccines Benefit Risk Expert Working Group. TS is supported by the National Institute for Health Research (NIHR) Health Protection Research Unit in Emerging and Zoonotic Infections, NIHR Programme Grant for Applied Research, NIHR Global Health Research Group on Brain Infections, the UK Medical Research Council's Global Effort on COVID-19 Programme, and the European Union{\textquoteleft}s Horizon 2020 research and innovation program ZikaPLAN (Preparedness Latin America Network). MSE reports royalties for a chapter on COVID-19 and neurological disease in UpToDate. All other authors declare no competing interests. Publisher Copyright: {\textcopyright} 2021 The Authors",
year = "2021",
month = aug,
day = "15",
doi = "10.1016/j.jns.2021.117532",
language = "English (US)",
volume = "427",
journal = "Journal of the Neurological Sciences",
issn = "0022-510X",
publisher = "Elsevier",
}
