A rare case of vaccine-induced immune thrombosis and thrombocytopenia and approach to management

India, 16 August 2021, Kotal et al, Surgical Neurology International

Summary

We report here a case of VITT in a 32 year old female who presented 11 days after receiving the first dose of the Covishield vaccine, with severe headache and hemiparesis. She was diagnosed with CSVT with a large intraparenchymal bleed, requiring decompressive craniectomy and extended period on mechanical ventilation. The patient was treated with intravenous immunoglobulin and discharged after 19 days in ICU with long-term neurological deficits.

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(a) MRI brain T2-weighted-GRE axial view showing right parietal hemorrhage. (b) MR venogram 2D TOF MIP coronal view showing complete thrombosis of the left transverse and sigmoid sinuses and partial thrombosis of superior sagittal sinus. (c) CT venogram 3D volume rendering technique showing complete thrombosis of the left transverse and sigmoid sinuses and partial thrombosis of superior sagittal sinus. (d) CT brain axial view showing increase in midline shift. (e) CT axial view after right parietal decompression craniectomy.

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