Cerebral Sinus Thrombosis and Immune Thrombocytopenia Post COVID-19 Vaccination: A Case Report and Narrative Review

Abstract

Vaccine-induced immune thrombocytopenia and thrombosis (VITT) following the adenoviral vector COVID-19 vaccine is a rare adverse event. Although the risk of VITT following the COVID-19 vaccine appears to be low, early diagnosis and management can be lifesaving. We present a case of VITT in a young female who presented with persistent headaches and fevers followed by anisocoria and right-sided hemiplegia. Initial imaging was unremarkable, and labs showed thrombocytopenia and elevated d-dimers. Repeat imaging revealed thrombosis in the left transverse and superior sagittal sinuses, and she was diagnosed with VITT. She received combined treatment with intravenous immunoglobulins and systemic anticoagulation, resulting in an increased platelet count and resolution of her neurological symptoms.

Using Diagnostic Radiological Imaging Modalities to Explore Neurological Dysfunction and Renal Failure in the Intersection of Hemophagocytic Lymphohistiocytosis, Macrophage Activation Syndrome, and Lupus

“…Macrophage activation syndrome (MAS) and Hemophagocytic lymphohistiocytosis (HLH) are rare and severe hyperinflammatory conditions that can have various clinical presentations on multiple organ systems, such as renal, bone marrow, liver, and spleen [ 1 ]. In some cases, these syndromes can manifest with atypical and alarming neurological symptoms such as seizures, cerebritis, and blindness [ 1 ]. This presentation is particularly challenging for both patients and healthcare providers, as it underscores the diverse and potentially life-threatening nature of these disorders [ 1 ].…”

“…In some cases, these syndromes can manifest with atypical and alarming neurological symptoms such as seizures, cerebritis, and blindness [ 1 ]. This presentation is particularly challenging for both patients and healthcare providers, as it underscores the diverse and potentially life-threatening nature of these disorders [ 1 ]. This introduction provides a glimpse into the complexity of MAS and HLH when they involve the nervous system, emphasizing the critical need for early recognition and intervention.…”