Cerebral Venous Sinus Thrombosis without Thrombotic Thrombocytopenic Syndrome in a Male Patient after Ad26.COV2.S Vaccination

Kara L Heuvelhorst¹, Tyler Diener¹, Hana Manzoor^1, , Maher Khadra¹, Faisal Musa¹ and Syed K Jafri¹

¹Departments of Radiology and Hematology-Oncology, Beaumont Hospital Dearborn, 18101 Oakwood Blvd, Dearborn, MI 48124

Cite this paper

Kara L Heuvelhorst, Tyler Diener, Hana Manzoor, Maher Khadra, Faisal Musa and Syed K Jafri. Cerebral Venous Sinus Thrombosis without Thrombotic Thrombocytopenic Syndrome in a Male Patient after Ad26.COV2.S Vaccination. American Journal of Medical Case Reports. 2021; 9(12):719-721. doi: 10.12691/AJMCR-9-12-15

Abstract

Objective: Here we present one of the first cases of Janssen (Johnson & Johnson Ad26.COV2.S vaccine-associated cerebral venous sinus thrombosis (CVST) in a male patient, and the presumed first case without associated thrombotic thrombocytopenic syndrome (TTS). Method: Patient was identified as a vaccine-related adverse effect due to the unusual presentation of CVST in a male following COVID-19 vaccination, though without thrombocytopenia. Results: Patient presented with left-sided weakness and transient dysarthria. Imaging revealed extensive CVST. Thorough coagulopathy work-up was negative and platelet levels remained within the normal range. Patient improved with non-heparin anticoagulation. Discussion: As more people worldwide continue to be vaccinated against COVID-19, the incidence of vaccine-related complications can be expected to rise. Multiple cases of CVST have been reported in patients following COVID-19 vaccination with associated TTS, nearly all in women. However, this is not the only presentation. Cerebral venous sinus thrombosis should be a consideration in patients who present with headache or altered mental status after COVID vaccination, despite normal platelet levels.

Keywords

Cerebral Venous Sinus Thrombosis, Vaccine, Johnson & Johnson, Janssen, AstraZeneca, Clot, COVID-19, FDA, CDC, anti-PF4, Thrombotic Thrombocytopenic Syndrome, Ad26.COV2.S

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References

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