Clinical review of cerebral venous thrombosis in the context of

J. Neurol. Sci. · Aug 2021

Review

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

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. ⋯ 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.

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- 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 Solomon, and Mitchell S Elkind.
- Department of Neurology, Columbia University Irving Medical Center/New York Presbyterian Hospital, New York, NY, USA. Electronic address: ktt2115@cumc.columbia.edu.
- J. Neurol. Sci. 2021 Aug 15; 427: 117532.
BackgroundVaccine 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.MethodsA collaborative comprehensive review of literature was conducted among a global group of expert neurologists and hematologists.FindingsStrategies 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.Copyright © 2021 The Authors. Published by Elsevier B.V. All rights reserved.

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

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