Clinical review of cerebral venous thrombosis in the context of COVID-19 vaccinations: Evaluation, management, and scientific questions

Kiran T. Thakur*, Arina Tamborska, Greta K. Wood, Emily McNeill, David Roh, Imo J. Akpan, Eliza C. Miller, Alyssa Bautista, Jan Claassen, Carla Y. Kim, Alla Guekht, Carlos A. Pardo, Olajide Williams, David García-Azorín, Kameshwar Prasad, Erich Schmutzhard, Benedict D. Michael, Sherry H.Y. Chou, Andrea S. Winkler, Tom SolomonMitchell S. Elkind

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

11 Scopus citations

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.

Original languageEnglish (US)
Article number117532
JournalJournal of the Neurological Sciences
Volume427
DOIs
StatePublished - Aug 15 2021
Externally publishedYes

Keywords

  • COVID-19
  • Cerebral venous thrombosis
  • Vaccination

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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