Prolonged migraine aura resembling ischemic stroke following CoronaVac vaccination: an extended case series

Suwanwela, Nijasri C.; Kijpaisalratana, Naruchorn; Tepmongkol, Supatporn; Rattanawong, Wanakorn; Vorasayan, Pongpat; Charnnarong, Chutibhorn; Tantivattana, Jarturon; Roongruang, Sirigunya; Ongphichetmetha, Tatchaporn; Panjasriprakarn, Poonnakarn; Chutinet, Aurauma; Akarathanawat, Wasan; Saver, Jeffrey L.

doi:10.1186/s10194-022-01385-0

Cited by 17 publications

(13 citation statements)

References 28 publications

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“…In MRI, patients of hemiplegic migraine can exhibit a mild atrophic cerebellum and many hyperintense lesions of the cerebral white matter without symptoms. However, the remarkable MRI presentation lacks specificity while other examinations appear normal (112)(113)(114).…”

Section: Hemiplegic Migrainementioning

confidence: 99%

Advances in differential diagnosis of cerebrovascular diseases in magnetic resonance imaging: a narrative review

Li¹,

Su²,

Yuan³

et al. 2023

Quant Imaging Med Surg

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Background and Objective: Cerebrovascular diseases (CVDs), particularly cerebral stroke, remain a primary cause of disability and death worldwide. Accurate diagnosis of CVDs is essential to guide therapeutic decisions and foresee the prognosis. Different CVDs have different pathological processes while they have many signs in common with some other brain diseases. Thus, differential diagnoses of strokes from other primary and secondary CVDs are especially important and challenging.Methods: This review is composed mainly based on searching PubMed articles

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Section: Hemiplegic Migrainementioning

confidence: 99%

Advances in differential diagnosis of cerebrovascular diseases in magnetic resonance imaging: a narrative review

Li¹,

Su²,

Yuan³

et al. 2023

Quant Imaging Med Surg

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“…Ähnlich beschrieben Suwanwela und Kollegen in einer Fallserie 8 Patient:innen, die nach der Impfung mit dem chinesischen Impfstoff CoronaVac® innerhalb von 60 min auraartige Beschwerden entwickelten, die für bis zu 14 Tage anhielten und zum Teil mit Kopfschmerzen einhergingen. Die Mehrzahl der Patient:innen hatte eine Migräneanamnese und war weiblich [ 31 ]. Auch wird in der Literatur das Auftreten eines reversiblen zerebralen Vasokonstriktionssyndroms (RCVS) im Zusammenhang mit einer COVID-19-Impfung beschrieben [ 8 ] sowie auch einer reversiblen intrakraniellen Hypertension [ 32 ].…”

Section: Diskussionunclassified

COVID-19-Impfung-assoziierte anhaltende Kopfschmerzen: Wie einordnen?

Straube

Ruscheweyh

Klonowski

2023

Schmerz

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Einleitung Im Rahmen einer akuten COVID-19-Infektion (Coronavirus SARS-CoV‑2 Infektion) treten in 10–60 % der Patient:innen Kopfschmerzen auf, die Tage und in einem kleineren Teil (ca. 10 %) der Patient:innen Wochen oder länger anhalten können. Weniger bekannt ist aber, dass auch nach einer COVID-19-Impfung anhaltende Kopfschmerzen auftreten können. Methode Retrospektive Beschreibung der Kopfschmerzen und des Verlaufs in einer Fallserie von 32 ambulanten Patienten mit anhaltenden Kopfschmerzen, die sich in zeitlichem Zusammenhang mit einer COVID-19-Impfung verstärkt haben oder neu aufgetreten sind. Ergebnis In der Mehrzahl der Patient:innen kam es zur Verstärkung eines vorbestehenden Migränekopfschmerzes. Bei 2 Patient:innen traten seltene sekundäre Kopfschmerzsyndrome wie intrakranielle Hypertension oder Donnerschlagkopfschmerz auf. Die Kopfschmerzen manifestierten sich in über 50 % der Patient:innen innerhalb der ersten 48 h nach Impfung. Über 50 % der Patient:innen sprachen auf eine Akuttherapie mit einem Triptan an. Schlussfolgerung Über den pathophysiologischen Zusammenhang zwischen Impfung und anhaltenden Kopfschmerzen bestehen noch keine klaren Vorstellungen. Die kurze Latenz, die partielle Wirksamkeit von Kortison und erste Befunde, die eine Erhöhung von verschiedenen Entzündungsmarkern im Verlauf der Kopfschmerzen bei COVID-Infektion zeigen, weisen auf eine mögliche Beteiligung des angeborenen Immunsystems und hier des Inflammasoms hin. Des Weiteren weist das Ansprechen auf eine Triptangabe bei einem Teil der Patienten auf eine Aktivierung des trigeminovaskulären Systems hin.

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“… A recent report from Thailand highlights a large number of cases with a distinctive focal neurological syndrome among those receiving the Chinese vaccine CoronaVac but not with the AstraZeneca vaccine [ 46 •]. This develops within the first few days of the first dose of vaccination and consists of transient hemisensory or hemimotor disturbances, at times associated with visual phenomenon developing in the corresponding hemifield of vision.…”

Section: Stroke Mimics and Covid-19 Vaccinationmentioning

confidence: 99%

Neurological Complications Following COVID-19 Vaccination

Chatterjee

Chakravarty

2022

Curr Neurol Neurosci Rep

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Purpose of Review A variety of neurological complications have been reported following the widespread use of the COVID-19 vaccines which may lead to vaccine hesitancy and serve as a major barrier to the public health aim of achieving protective herd immunity by vaccination. In this article, we review the available evidence regarding these neurological adverse events reported, to provide clarity regarding the same so that unfounded fears maybe put to rest. Recent Findings There is a greater than expected occurrence of severe neurological adverse events such as cortical sinus venous thrombosis, Bell’s palsy, transverse myelitis, and Guillain–Barré syndromes along with other common effects such as headaches following different kinds of COVID-19 vaccination. Precipitation of new onset demyelinating brain lesions with or without detection of specific antibodies and worsening of pre-existing neurological disorders (like epilepsy, multiple sclerosis) are also a matter of great concern though no conclusive evidence implicating the vaccines is available as of now. Summary The COVID-19 pandemic is far from being over. Till such time that a truly effective anti-viral drug is discovered, or an appropriate therapeutic strategy is developed, COVID-appropriate behavior and highly effective mass vaccination remain the only weapons in our armamentarium to fight this deadly disease. As often occurs with most therapeutic means for the treatment and prevention of any disease, vaccination against COVID-19 has its hazards. These range from the most trivial ones like fever, local pain and myalgias to several potentially serious cardiac and neurological complications. The latter group includes conditions like cerebral venous thrombosis (curiously often with thrombocytopenia), transverse myelitis and acute inflammatory demyelinating polyneuropathy amongst others. Fortunately, the number of reported patients with any of these serious complications is far too low for the total number of people vaccinated. Hence, the current evidence suggests that the benefits of vaccination far outweigh the risk of these events in majority of the patients. As of now, available evidence also does not recommend withholding vaccination in patients with pre-existing neurological disorders like epilepsy and MS, though adenoviral vaccines should be avoided in those with history of thrombotic events.

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Prolonged migraine aura resembling ischemic stroke following CoronaVac vaccination: an extended case series

Cited by 17 publications

References 28 publications

Advances in differential diagnosis of cerebrovascular diseases in magnetic resonance imaging: a narrative review

Advances in differential diagnosis of cerebrovascular diseases in magnetic resonance imaging: a narrative review

COVID-19-Impfung-assoziierte anhaltende Kopfschmerzen: Wie einordnen?

Neurological Complications Following COVID-19 Vaccination

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