Cerebral Thrombosis After The Pfizer Covid-19 Vaccine

A case report study presented two women who developed cerebral venous thrombosis (CVT). The CVT was reported in two females after having the Pfizer/Biontech BNT162b2 mRNA SARS-CoV-2 vaccine.

CVT is the formation of blood clots inside the dural sinuses of the brain. The dural sinuses drain venous blood from the brain.

CVT is a life-threatening medical emergency. It can lead to loss of vision, eye swelling or chemosis, exophthalmos (bulging eyes), headaches, seizures, and paralysis of the extremities and cranial nerves.

Cerebral Thrombosis After The Pfizer Covid-19 Vaccine — The Dural Venous Sinuses Are In Blue. Source: Wikipedia

Case 1 is a 47-year-old female who developed persistent headache, nausea, and photophobia six days after the first vaccine dose. Three days later, she presented a sudden left-sided weakness. Papilledema, left visual extinction, right gaze deviation, and left hemiparesis were documented.

Her MRI with venography showed thrombosis of superior sagittal, right lateral, transverse, sigmoid sinuses and jugular vein and left sigmoid sinus, together with right frontal subarachnoid hemorrhage and a cortical venous infarct.

Case 2 is a 67-year-old female.

Three days after the second vaccine dose, she presented with sudden right lower limb clonic movements, followed by motor deficit, loss of consciousness and headache.

Brain MRI showed thrombosis of high convexity cortical veins, superior sagittal, right transverse, and sigmoid sinus and jugular vein. There were no signs of hemorrhage.

The clonic movements were suspicious for a focal seizure, and an EEG confirmed the seizure disorder.

Both cases survived. However, the 47-year-old still has gait instability after two months. The 67-year-old was started on anti-seizure medication. Both were discharged on blood thinners.

To explain the CVT formation, the case report authors said that the modified RNA in the Pfizer vaccine was translated into spike proteins that elicited antibody production.

The anti-spike protein antibodies then initiated a pro-inflammatory cascade that triggered blood clotting.

The mechanism for CVT formation in the Pfizer vaccine is different from the CVTs that occurred after the Astra Zeneca and Janssen COVID-19 vaccines.

In both AstraZeneca and Johnson and Johnson vaccines, low platelet counts and antiplatelet-PF4-antibodies were detected. In contrast, low platelet counts and antiplatelet-PF4-antibodies were not detected in the Pfizer vaccine.

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1 CVT in AstraZeneca and Janssen COVID-19 Vaccines

1.1 Take-away message

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CVT in AstraZeneca and Janssen COVID-19 Vaccines

So far, 70 cases of Cerebro venous thrombosis (CVT) have been reported with the AstraZeneca vaccine (ChAdOx1 nCoV-19, Vaxzevria®). Five cases were reported with Janssen’s (Johnson & Johnson Ad26.COV2.S ).

The CVTs usually occur in women under 60 and happens up to two weeks post-vaccination. Both AstraZeneca and Janssen vaccines have the SARS-CoV-2 spike protein enveloped in an adenovirus vector.

Take-away message

Life-threatening blood clot formation in the brain in the form of cavernous sinus thrombosis can happen after injection with the Pfizer, AstraZeneca, and Johnson and Johnson COVID-19 vaccine.

If, after vaccination, you experience any headaches, nausea, loss of consciousness, focal weakness, or uncontrolled involuntary movement of any extremities, seek medical consultation right away or call 911.

Be sure to report any adverse vaccine reaction to the Vaccine Adverse Event Reporting System.

Knowledge about Covid-19 is rapidly evolving. Information may update as new studies are made. Stay current by subscribing. Feel free to share and like.

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