Epidemiology and Management of Cerebral Venous Thrombosis during the COVID-19 Pandemic

Cerebral venous thrombosis (CVT) is a rare type of stroke that may cause an intracranial hypertension syndrome as well as focal neurological deficits due to venous infarcts. MRI with venography is the method of choice for diagnosis, and treatment with anticoagulants should be promptly started. CVT i...

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Bibliographic Details
Published in:Life (Basel, Switzerland) Switzerland), 2022-07, Vol.12 (8), p.1105
Main Authors: Novaes, Natalia, Sadik, Raphaël, Sadik, Jean-Claude, Obadia, Michaël
Format: Article
Language:English
Subjects:
adenovirus vaccine
Antibodies
Anticoagulants
Blood clots
cerebral venous thrombosis
Coma
Convulsions & seizures
Coronaviruses
COVID-19
COVID-19 vaccines
Epidemiology
Hemorrhage
Heparin
Hospitalization
Hypertension
Literature reviews
Magnetic resonance imaging
Medical treatment
Mortality
Mutation
Neurological diseases
Pandemics
Patients
Review
Seizures
Sinuses
Thrombocytopenia
Thromboembolism
Thrombosis
Vaccination
vaccine-induced immune thrombotic thrombocytopenia (VITT)
Vaccines
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Summary:Cerebral venous thrombosis (CVT) is a rare type of stroke that may cause an intracranial hypertension syndrome as well as focal neurological deficits due to venous infarcts. MRI with venography is the method of choice for diagnosis, and treatment with anticoagulants should be promptly started. CVT incidence has increased in COVID-19-infected patients due to a hypercoagulability state and endothelial inflammation. CVT following COVID-19 vaccination could be related to vaccine-induced immune thrombotic thrombocytopenia (VITT), a rare but severe complication that should be promptly identified because of its high mortality rate. Platelet count, D-dimer and PF4 antibodies should be dosed. Treatment with non-heparin anticoagulants and immunoglobulin could improve recuperation. Development of headache associated with seizures, impaired consciousness or focal signs should raise immediate suspicion of CVT. In patients who received a COVID-19 adenovirus-vector vaccine presenting thromboembolic events, VITT should be suspected and rapidly treated. Nevertheless, vaccination benefits clearly outweigh risks and should be continued.
ISSN:2075-1729
2075-1729
DOI:10.3390/life12081105