This article features the literature review of Kakovan and colleagues’ Stroke Associated with COVID-19 Vaccines. The Journal of Stroke and Cerebrovascular Diseases published it in June 2022
The authors from Iran and Denmarkgathered several cases reported from all over the world and sorted them into the types of strokes and the COVID vaccines that are associated with them.
Why are case reports relevant?
Case reports are an excellent source of COVID-10 vaccine complications. That’s because the reports are written by physicians involved in the patients’ care and also ruled out the other causes of the strokes.
The association is made with the timing of the administration of the COVID-19 shots and the onset of stroke presentation. Thus it would be hard to argue that the strokes are just “coincidental.”
Writing a case report takes a lot of time and effort. Not all vaccine complications are reported, and the actual number of complications could be magnitudes higher than what is written.
Types of Strokes
There are different kinds of stroke: Ischemic Stroke (Loss of blood supply), Hemorrhagic from rupture of a blood vessel, and Cavernous Sinus Thrombosis (blood clot develops in the sinus drainage of the brain).
Why do strokes happen after the COVID-19 injections?
The blood clots that caused the strokes came from the spike proteins and the inflammatory cytokines produced as a response to them.
The spike proteins produced by the body after mRNA shots (Pfizer and Moderna) and the vector-based vaccines (AstraZeneca and Johnson, and Johnson/Janssen) can last for months and travel around the whole body in contrast to the claims by their manufacturers.
I discussed the studies about those topics at Intermittent fasting for Post COVID Vaccine Syndrome: Autophagy and 13 ways that the SARS-CoV-2 spike protein causes damage.
In general, COVID shots stimulate the immune system and result in the overproduction of pro-inflammatory cytokines like interleukins, chemokines, and monocyte chemoattractant proteins and interferons.
These cytokines travel in the bloodstream and elicit inflammation in the blood vessels. Once inflammation starts, the body attempts to repair what it perceives to be an injury, and the initial process is blood clot formation.
Novavax and Sputnik
Interestingly, the Novavax (NVX-CoV2373) that does not carry the RNA of the SARS-CoV-2 is not among those who caused the strokes in the tables below.
Novavax carries only the spike protein, which stimulates the immune system. However, the spike protein from the Novavax is eventually destroyed by the immune response it elicited and did not hang around to cause further inflammation.
That could be why Novavax has a lower rate of complications during its clinical trials compared to Pfizer and Moderna.
The other vector-based vaccine is Sputnik (rAd26-S and rAd5-S) from Russia. No strokes were associated with it in the tables below. However, Sputnik reported Deep Venous Thrombosis (1 case), Transient Ischemic attack (1), and Cerebral circulation failure (1) in their clinical trials.
How to use the information in this article
The time may come again that governments may mandate COVID booster shots. People have their reasons for getting the injections. So if you have to get the shot, you must read the rest of the article.
The essential takeaways from this article for the nonmedical person are the following:
- Know the clinical presentation. Constant headaches may be a sign, especially within four weeks after the COVID vaccination. If you see those in someone, vaccinated or not, call 911. Time (in minutes) is of the essence. Outcomes depend on how fast a stroke is diagnosed and treated.
- The interval days. Those are the days that the strokes usually happen.
- If you have the vector-based shots (AstraZeneca and Johnson and Johnson), the likelihood of strokes is higher, although it also exists with Pfizer and Moderna.
- Don’t worry about the imaging, lab findings, and treatment. That’s the doctors’ job.
- The links to the references are still active and are represented by red numbers in the left-most column.
Ischemic Strokes
Ischemic strokes happen when a blood clot obstructs blood flow to a part of the brain. The brain needs oxygen all the time.
If the blood flow is resumed promptly, long-lasting deficits may be averted, which is why immediate medical attention is needed.
Summary of reports of ischemic stroke cases following the COVID-19 vaccination.
Table 1 shows that most of the patients with ischemic stroke after COVID-19 vaccination were women within the age range of 26-60 years and after vaccination with AstraZeneca (ChAdOx1 nCoV-19) vaccines and within 1 to 21 days after the vaccination.
| Vaccine | Number of cases | Age Gender (F, M) | Interval (days) between vaccination and diagnosis | Clinical presentation | Imaging and lab findings | Treatment | Outcome | Author, year, ref |
|---|---|---|---|---|---|---|---|---|
| ChAdOx1 nCoV-19 (AstraZeneca) | 3 | 35-43 F = 2, M = 1 |
11-21 | Case 1: headache, left hemiparesis, right gaze preference, and drowsiness Case 2: diffuse headache, left visual field loss, confusion, and left arm weakness Case 3: dysphasia |
Case 1: Middle Cerebral Artery (MCA) infarct Case 2: ICA infart and CVST Case 3: MCA infarct Thrombocytopenia, positive anti-PF4 antibody, and increased D-dimer in all three patients |
Case 1: IVIg, plasmapheresis, Fondaparinux, and decompressive hemicraniectomy Case2: IVIg, plasmapheresis, methylprednisolone, and Fondaparinux Case 3: platelet transfusion, IVIg, and Fondaparinux |
Case1: death Case 2: improved clinically Case3: discharged with favorable clinical outcome |
Al-Mayhani et al., 202127 |
| 1 | 60 F = 1 |
8 | headache and left weakness, and eye deviation to the right | Ischemic stroke in the territory of Internal Carotid Artery (ICA) and MCA Thrombocytopenia, positive anti-PF4 antibody, and increased D-dimer |
Hydrocortisone, platelet concentrates, hemicraniectomy, and dalteparin | Death | Blauenfeldt et al., 2021(53) | |
| 1 | 26 F = 1 |
1 | Persistent nausea and headache and right hemiplegia, and aphasia | Ischemic stroke in the territory of MCA Thrombocytopenia, positive anti-PF4 antibody, decreased fibrinogen level |
Corticosteroids, plasmatic exchange, and anticoagulants | Only gripping difficulties and minor phasic troubles were remaining | Garnier et al., 202168 | |
| 23 | 21-77 (mean:46) F = 14 M = 9 |
6-24 (mean:12) | Not Mentioned (NM) | Thirteen cases of CVST Two cases of ischemic stroke antiPF4 antibody was positive in 22 patients Thrombocytopenia in 22 patients, low fibrinogen levels in 13 patients, and increased D-dimer levels in 21 patients |
NM | Seven patients died | Scully et al., 202169 | |
| 1 | 31 M=1 |
8 | Acute headache, aphasia, and hemiparesis | Occlusion of MCA with the source of thrombus ipsilateral in the carotid bulb, elevated D-dimer level slightly, and positive anti-PF-4 antibody |
IV thrombolysis, Aspirin, Danaparoid, Phenprocoumon | Favorable clinical outcome | Walter et al., 202170 | |
| 2 | Case 1 = 55, Case 2 = 57 F=2 |
Case 1 = 9, Case 2 = 10 | Case 1: left hemiplegia, right gaze deviation, dysarthria, and left neglect Case 2: aphasia, right hemiparesis, generalized seizures, and coma |
Ischemic stroke Thrombocytopenia, positive anti-PF4 antibody, and increased D-dimer level |
Case 1: mechanical thrombectomy, platelet transfusion, IVbetamethasone, IVIg, plasma exchange, fondaparinux Case 2: IVIg and dexamethasone |
Case 1: critical condition Case 2: Brain death |
De Michele et al., 202164 |
Note: MCA: Middle Cerebral Artery; CVST: Cerebral Venous Sinus Thrombosis; Anti -PF4-antibody: anti-platelet factor 4 antibody; IVIg: Intravenous Immunoglobulin; IV: Intravenous. Source: Kakovan et al. 2022
Intracranial Hemorrhage (ICH)
Intracranial hemorrhage happens due to a weakness of the blood vessel wall. Hypertension which occurs after vaccination is a significant factor.
Higher blood pressure after COVID shots and why it happens
A study by Finsterer et al. suggested that the second dose of SARS-CoV-2 vaccination may be followed by ICH even when the first dose was uneventful
Most of the cases were reported following administration of the AstraZeneca (ChAdOx1 nCoV-19) vaccine and in people 30–57 years of age, 5–12 days after the vaccination
Table 2. shows the summary of reports of ICH following the COVID-19 vaccination.
| Vaccine | Number of cases | Age Gender (F, M) | Interval (days) between vaccination and diagnosis | Clinical presentation | Imaging and lab findings | Treatment | Outcome | Author, year, ref |
|
|
||||||||
| ChAdOx1 nCoV-19 (AstraZeneca) | 1 | In her thirties F = 1 |
10 | Headache, lethargy, uncoordinated movements, reduced consciousness, aphasia, central left facial paresis with right gaze deviation, and left hemiparalysis. | ICH (MCA) Thrombocytopenia and positive anti-PF4 antibody Thrombi in the transverse sinus in autopsy |
IV tranexamic acid | Death | Bjørnstad et al., 202123 |
| 1 | 57 F=1 |
5 | Fever, headache, left hemiparesis, vomiting, and drowsiness | ICH | Decompressive craniectomy | On Day 15, left hemiparetic, obeying simple tasks, kept on tracheostomy | Silva et al., 202175 | |
| mRNA-based SARS-CoV-2 vaccine | 1 | 52 M=1 |
7 | aphasia | ICH in the temporal lobe | Sacubitril/valsartan, atorvastatin, and bisoprolol in the rehabilitation | Aphasia resolved | Finsterer et al., 202179 |
| ChAdOx1 nCoV-19 (Vaxzervia) | 1 | 52 M = 1 |
12 | Intense headache, GCS;6 | ICH Thrombocytopenia, elevated fibrin D-dimer level, low fibrinogen level, slightly increased INR. |
Tranexamic acid, platelet concentrate | Death | Wolthers et al.,202180 |
Note: MCA: Middle Cerebral Artery; Anti-PF4-antibody: anti-platelet factor 4 antibody; ICH: Intracerebral Hemorrhage; INR: International Normalized Ratio; IV: Intravenous; GCS: Glasgow Coma Scale. Source: Kakovan et al. 2022
Cavernous Venous Sinus Thrombosis (CVST)
CVST occurs when blood clot forms in the brain’s venous sinus system drainage system. It results in localized brain edema, raised intracranial pressure (ICP), infarction, and rarely intracranial hemorrhage.
The most common symptom is a headache.
Kakovan et al. said CVST usually has a good prognosis. However, CVST after COVID-19 vaccination may follow a catastrophic course. The outcome for these patients may be poor due to refractory increased ICP; indeed, almost half of patients with CVT in the context of VITT die within a few days, and death often occurs following brain infarction often associated with ICH. [1]
Table 3 Summary reports of Cavernous Venous Sinus Thrombosis (CVST) following the COVID-19 vaccination.
The table shows that most patients were female at 24-56 years of age. Most of these CVST cases were reported following ChAdOx1 nCoV-19 vaccine administration.
Furthermore, all of the patients received the vaccine 7-20 days before the diagnosis of stroke.
| Vaccine | Number of cases | Age, Gender (F, M) | Interval (days) between vaccination and diagnosis | Clinical presentation | Imaging and lab findings | Treatment | Outcome | Author, year, ref |
|---|---|---|---|---|---|---|---|---|
| ChAdOx1 nCoV-19, Pfizer (BNT162b2 mRNA), and Moderna mRNA-1273 | A total of 213 ChAdOx1 nCoV-19 (187 patients), BNT162b2 mRNA (25 patients), and mRNA-1273 (1 patient) |
Median of age: 46 75% women in ChAdOx1 nCoV-19 recipients and 77% in mRNA vaccine recipients |
Nine days in the ChAdOx1 nCov-19 group and 7 days in the mRNA vaccine group | NM | CVST in all of the patients Thrombocytopenia in 107 patients amongst 187 patients receiving the ChAdOx1 nCoV-19 vaccine |
NM | Of the 117 patients with a reported outcome in the ChAdOx1 nCov- 19 group, 44 died, compared to 2 deaths out of 10 deaths with reported outcome in the mRNA vaccine group and 3 deaths out of 100 patients with reported outcome in the pre- COVID- 19 group. | Krzywicka et al., 202194 |
| 1 | 49 M=1 |
20 | New-onset of mild to moderate headache and giddiness | CVST | Clexane, clopidogrel, and apixaban | Symptoms gradually improved | Zakaria et al., 202195 | |
| ChAdOx1 nCoV-19 (COVISHIELD) | 1 | 56 M=1 |
14 | Persistent holocranial headache associated with vomiting, and double vision in horizontal gaze | CVST | LMWH and warfarin | Significant improvement in clinical status | Dutta et al., 202196 |
| ChAdOx1 nCoV-19 (AstraZeneca) | 1 | 52 M = 1 |
10 | Nausea and thunderclap headache and pain on the left side of the neck | CVST Thrombocytopenia, positive anti-PF4 antibody, and elevated D-dimer level |
Apixaban and IVIg | Discharged without any symptoms | Guan et al., 202197 |
| 2 | NM | NM | NM | CVT thrombocytopenia |
Heparin, corticosteroid, IVIg in one patient, and decompressive craniectomy in both patients |
Death | Geeraerts et al., 202198 | |
| 1 | 36 F=1 |
14 | Fever with vomiting and severe headache, and sudden onset of focal left-sided convulsions for 5 min followed by weakness in the left arm. |
CVST Thrombocytopenia, hypofibrinogenemia, leukocytosis, anemia, increased D-dimer level, and liver enzymes, high creatinine severe acidosis (acute kidney injury), and prolonged PT, PTT, and INR |
Enoxaparin, antibiotics, and antivirals | Death | Aladdin et al., 202199 | |
| 2 | 24,39 F = 2 |
8, 12 | Case 1: severe holocephalic headache(before admission), new left dull occipital headache(during admission) Case 2: severe persisting headache |
Case 1: CVST Case 2: CVT with related small frontal right juxtacortical hemorrhage Thrombocytopenia, positive anti-PF4 antibody, increased D-dimer, and decreased fibrinogen level |
Case 1: danaparoid, dexamethasone, IVIg, argatroban, and dabigatran Case 2: IVIg, dexamethasone, and argatroban |
Cases 1 and 2: discharged without any symptoms | Gattringer et al., 2021100 | |
| Ad26.COV2.S (Johnson & Johnson/ Jansen) | 1 | 40 F = 1 |
12 | Headache, sinus pressure, myalgias, sore throat with tonsillar exudate, photophobia, and intermittent dizziness | CVST Thrombocytopenia increased D-dimer levels and mild elevation of serum transaminases |
Bivalirudin, IVIg, prednisone | Resolution of headache and a steady improvement in laboratory markers of thrombocytopenia | Clark et al., 2021101 |
| 1 | 48 F = 1 |
14 | New-onset headache | CVST Severe thrombocytopenia, low fibrinogen level, prolonged activated partial thromboplastin time, and marked elevation of the D-dimer level |
UFH, Argatroban and IVIg | Remained critically ill | Muir et al., 2021102 | |
| 1 | 43 F=1 |
10 | Generalized headache, fever, body aches, chills, mild dyspnea, and lightheadedness | CVST Thrombocytopenia, positive anti-PF4 antibody, and elevated D-dimer level |
IVIg and fondaparinux | TIA one day after discharge | Malik et al., 2021103 |
Note: CVST: Cerebral Venous Sinus Thrombosis; Anti-PF4-antibody: anti-platelet factor 4 antibody; TIA: Transient Ischemic Attack; LMWH: Low Molecular Weight Heparin; IVIg: Intravenous Immunoglobulin; UFH: Unfractionated Heparin; NM: Not Mentioned; CRP: C-Reactive Protein); mRNA: messenger Ribonucleic Acid; COVID-19: coronavirus disease 2019; PT: Prothrombin Time; PTT: Partial Thromboplastin Time; INR: International Normalized Ratio; aPTT: activated Partial Thromboplastin Time. Source: Kakovan et al. 2022
Ischemic and Hemorrhagic Stroke After CVST
Table 4 shows that most patients were female at 18-77 years of age. Most of these CVST cases were reported following ChAdOx1 nCoV-19 vaccine administration. Moreover, these patients received the vaccine 2-24 days before stroke diagnosis.
| Vaccine | Number of cases | Age Gender (F, M) | Interval (days) between vaccination and diagnosis | Clinical presentation | Imaging and lab findings | Treatment | Outcome | Author, year, ref |
|---|---|---|---|---|---|---|---|---|
| ChAdOx1 nCoV-19 (AstraZeneca) | 23 | 21-77 (mean:46) F = 14 M = 9 |
6-24 (mean:12) | NM | Thirteen cases of CVST Two cases of ischemic stroke Positive antiPF4 antibody in 22 patients Thrombocytopenia in 22 patients, low fibrinogen levels in 13 patients, and increased D-dimer levels in 21 patients |
NM | Seven patients died | Scully et al., 202169 |
| ChAdOx1 nCoV-19 (AstraZeneca) | 1 | 50 M = 1 |
11 | Headache, slight deviation of the right buccal rim, loss of strength in the right lower limb, unstable walking, and slight visual impairment | ICH CVST Thrombocytopenia, low fibrinogen level, increased amounts of D-dimer, CRP, and homocysteine |
Bilateral decompressive craniectomy | Brain death | Castelli et al., 202171 |
| ChAdOx1 nCoV-19 (AstraZeneca) | 1 | 54 F = 1 |
12 | Left side signs | ICH CVST Thrombocytopenia and elevated D-dimer level |
NM | Death | D’Agostino et al., 202172 |
| ChAdOx1 nCoV-19 (AstraZeneca) | 1 | 50 M=1 |
11 | Headache, unconsciousness | ICH CVST Thrombocytopenia, positive anti-PF4 antibody, increased prothrombin time and D-dimer, low fibrinogen level, hypohomocysteinemia, and low folic acid level |
Red blood cell and platelet apheresis transfusion, infusion of fibrinogen concentrate, neurosurgical intervention | Death | Franchini et al., 202173 |
| ChAdOx1 nCoV-19 (AstraZeneca) | 2 | Case 1 = 25, Case 2 = 32 M=2 |
Case 1 = 6, Case 2 = 9 | Case 1: thunderclap headache, left- incoordination, and hemiparesis Case 2: headache with photophobia, neck stiffness, visual disturbances associated with a non-blanching petechial rash over lower limbs, bleeding of gums, left hemiparesis and hemisensory loss, and focal motor seizures |
ICH, SAH CVST Thrombocytopenia and low fibrinogen level |
Case 1: no specific hematological or immunological treatments were administered Case 2: UFH, platelet transfusions, dexamethasone, IVIg |
Brain stem death | Mehta et al., 202174 |
| ChAdOx1 nCoV-19 (AstraZeneca) | 1 | In the early 30s F=1 |
10 | Mild myalgia, holocephalic headache, chills, and persisting headaches | CVST ICH Thrombocytopenia, positive anti-PF4 antibody, elevated D-dimer level |
Argatroban, IVIg, and argatroban | Persistent minimal gait ataxia and amnestic deficits | Ikenberg et al., 202176 |
| ChAdOx1 nCoV-19 (AstraZeneca) | 1 | 69 F=1 |
13 | Headache associated with behavioral symptoms and decreased level of consciousness | CVST ICH Thrombocytopenia, positive anti-PF4 antibody |
NM | Brain death | Jamme et al., 2021104 |
| ChAdOx1 nCoV-19 (AstraZeneca) | 1 | 33 M=1 |
12 | Headache, vomiting, sudden onset of a tingling in the right arm, mental change, drowsiness, dysarthria, and right hemiparesis | ICH, SAH, and CVT Thrombocytopenia, elevated D-dimer level, low fibrinogen level, and positive anti-PF4 antibody |
FFP, platelet concentrate, IVIg, methylprednisolone, and thrombectomy | Death | Choi et al., 2021105 |
| ChAdOx1 nCoV-19 | 3 | 22-46 F=3 |
7-17 | Case 1: new frontally accentuated headache, a self-limited generalized epileptic seizure Case 2: severe headache, mild aphasia, hemianopia to the right, somnolence Case 3: severe headache, acute somnolence, and right-hand hemiparesis |
Case 1:CVST, SAH Case 2: CVST. ICH Case 3: CVST Thrombocytopenia and positive anti-PF4 antibody in all the three patients |
Case 1: endovascular rheolysis, levetiracetam, enoxaparin, and dabigatran Case 2: enoxaparin, danaparoid, and dabigatran Case 3: danaparoid, endovascular rheolysis, enoxaparin, and dabigatran |
Case 1: mRS 0 Case 2: mRS 1 Case 3: mRS 0 |
Wolf et al., 2021106 |
| ChAdOx1 nCoV-19 (AstraZeneca) | 11 | 22-49 F = 9: M = 2 |
5-16 | NM | CVST in 9 patients ICH in one patient Thrombocytopenia in all of the patients and positive anti-PF4 antibody in one patient |
NM | Death in 6 patients, recovery in 4 patients, No information about one patient |
Greinacher et al., 202178 |
| ChAdOx1 nCoV-19 (AstraZeneca) | 4 | 41-67 F = 4 |
5-11 | Case 1: headache, somnolence, dysphasia, right hemiparesis, and arterial hypertension Case 2: headache Case 3: headache and diplopia Case 4: headache, dysarthria, left- hemiplegia, and conjugated gaze palsy |
Case 1: CVST and ICH Case 2: cortical infarctions and aortic arch thrombi Case 3: no pathology in imaging findings Case 4: ischemic stroke in ICA and MCA territory with hemorrhagic transformation Thrombocytopenia, increased D-dimer level, positive anti-PF4 antibody in all of the patients |
Case 1: heparin and eculizumab Case 2: argatroban and IVIg Case 3: argatroban Case 4: argatroban and IVIg |
Case 1: Recovering Case 2, 3, and 4: Recovered |
Tiede et al., 2021107 |
| ChAdOx1 nCoV-19 (AstraZeneca) | 4 | 37-54 F= 4 |
7-10 | Case 1: fever and persistent headaches Case 2: headaches, reduced consciousness Case 3: headache Case 4: hemiparesis |
Case 1: CVST and ICH Case 2: CVST and hemorrhagic infarction Case 3: CVT and hemorrhagic infarction Case 4: ICH and CVT Thrombocytopenia and positive anti-PF4 antibody in all of the patients |
Case 1: platelet transfusions and decompressive craniectomy Case 2: hemicraniectomy, dalteparin, methylprednisolone, IVIg Case 3: dalteparin, prednisolone and IVIg Case 4: platelet transfusion, methylprednisolone, IVIg, thrombectomy, UFH, and decompressive hemicraniectomy |
Case 1: death Case 2: death Case 3: full recovery Case 4: death |
Schultz et al., 202193 |
| ChAdOx1 nCoV-19 (AstraZeneca) | 1 | 27 M=1 |
12 | Intermittent headache associated with eye floaters and vomiting. | CVST ICH Thrombocytopenia, positive anti-PF4 antibody, raised D- dimer, low platelets, and fibrinogen levels |
IVIg, dabigatran, idarucizumab, and prednisolone | Death | Suresh et al., 202126 |
| ChAdOx1 nCoV-19 (AstraZeneca) | 1 | 62 M = 1 |
13 | Fever, weakness in the right arm, and mental confusion | CVST, SAH, Large parietal hematoma (after receiving heparin), Acute myocardial infarction Increased CRP, leukocytosis, thrombocytopenia, increased D-dimer level, increased high-sensitivity cardiac troponin I level, positive anti-PF4 antibody |
Antibiotics, platelet concentrate, UFH, intravenous methylprednisolone | Death | Bérezné et al., 2021108 |
| ChAdOx1 nCoV-19 (Covishield) | 1 | 32 F = 1 |
11 | Headache associated with blurred vision and giddiness, weakness on the left upper and lower limb | CVST and ICH Thrombocytopenia increased D-dimer, positive anti-PF4 antibody |
Enoxaparin, parietal decompressive hemicraniectomy, fondaparinux, IVIg, tracheostomy | Discharged with home neurorehabilitation service | Kotal et al., 2021109 |
| Ad26.COV2.S (Johnson & Johnson/ Jansen) | 12 | 18-60 F = 12 |
6-15 | Eleven patients initially presented with headaches, and one patient initially showed back pain and later developed a headache | CVST (of the 12 patients with CVST, seven also had ICH) Thrombocytopenia and elevated D-dimer level, and decreased fibrinogen level |
Heparin treatment (later changed to non-heparin anticoagulant) in 6 patients; No anticoagulant therapy in 2 patients Non-heparin anticoagulant initially for CVST treatment in 4 patients. In addition to anticoagulation, seven patients received IVIg of which three also received systemic corticosteroids and four had platelet transfusions. |
Death (n = 3), ICU care (n = 3), non-ICU hospitalization (n = 2), and discharged (n = 4) | See et al., 2021110 |
| mRNA-1273 | 1 | 45 M = 1 |
8 | Headache, neck pain, altered mental state after a witnessed seizure (GCS: 3) | ICH, SAH, and CVST |
Heparin and coumadin | Discharged with no neurological sequel | Syed et al., 2021111 |
| BNT162b2 mRNA(Pfizer) | 2 | 47, 67 F=2 |
3, 6 | Case 1: persistent headache, nausea, photophobia, and sudden left motor deficit Case 2: sudden right lower limb clonic movements followed by motor deficit, loss of consciousness, and headache |
Case 1: CVST and SAH Case 2: CVST |
Case 1: enoxaparin and warfarin Case 2: enoxaparin, and dabigatran |
Case 1: slight gait instability at two-month follow-up Case 2: discharged without neurological deficits |
Dias et al., 2021112 |
| BNT162b2 mRNA (Pfizer-Biontech | 3 | 54-62 F = 2 M = 1 |
2-9 | Case 1: headache, vomiting, and left hemiparesis Case 2: headache and vomiting Case 3: right ataxic hemiparesis |
Case 1: ICH and CVST Case 2: ICH, SAH, and CVST Case 3: ICH, SAH, and CVST |
Case 1: UFH and LMWH Case 2: UFH, LMWH, warfarin, and decompressive craniectomy Case 3: LMWH, warfarin |
Cases 1 and 2: Left hemiparesis, on rehabilitation Case 3: Full recovery |
Fan et al., 2021113 |
Note: MCA: Middle Cerebral Artery; ICA: Internal Carotid Artery; CVST: Cerebral Venous Sinus Thrombosis; CVT: Cerebral Venous Thrombosis; Anti-PF4-antibody: anti-platelet factor 4 antibody; ICH: Intracerebral Hemorrhage; SAH: Subarachnoid Hemorrhage; LMWH: Low Molecular Weight Heparin; IVIg: Intravenous Immunoglobulin; UFH: Unfractionated Heparin; ICU: Intensive Care Unit; mRS: modified Rankin Scale; NM: Not Mentioned; CRP: C-Reactive Protein; FFP: Fresh Frozen Plasma; GCS: Glasgow Coma Scale. Source: Kakovan et al. 2022
Take away message
Anytime you suspect someone is having a stroke, call 911!
Don’t Get Sick!
Knowledge about Covid-19 is rapidly evolving. Stay current by subscribing. Feel free to share and like.
Please consider donating to show your support if you find value in this website.
Related:
- Acute Transverse Myelitis Cases after COVID Vaccinations
- Noninfectious vaginal ulcers after AstraZeneca COVID shot
- Neuropathic symptoms following COVID-19 vaccination
- A report on Kidney failures after COVID vaccinations
- Complete Heart Block after the Pfizer COVID shot
- Retinal complications after COVID shots
- RNA splice study shows why AstraZeneca and Janssen jabs are clot shots
- Blood Vessel Damaging Proteins of the SARS-CoV-2
- Cerebral Thrombosis after the Pfizer Covid-19 Vaccine
- The High Risk of Deadly Brain Clots in the J & J COVID Vaccine
- This study shows a Ten-Fold Risk of Developing Blood Clots after the COVID Vaccines.
- Platelet Changes Causes Blood Clots in COVID-19
- Unidentified Foreign Bodies in the Vaccines Form Clots
Reference:
- Kakovan M, Ghorbani Shirkouhi S, Zarei M, Andalib S. Stroke Associated with COVID-19 Vaccines. J Stroke Cerebrovasc Dis. 2022 Jun;31(6):106440. doi: 10.1016/j.jstrokecerebrovasdis.2022.106440. Epub 2022 Mar 4. PMID: 35339857; PMCID: PMC8894799.
Authors retain the copyright. No copyright infringement intended.
© 2018 – 2022 Asclepiades Medicine, L.L.C. All Rights Reserved
DrJesseSantiano.com does not provide medical advice, diagnosis, or treatment
Your website did not confirm that my comment was sent! Maybe because I used my other email address, not the one already associated with my subscription.
Trying again:
You say “The blood clots that caused the strokes came from the spike proteins …”; but I could not find where you explain how they do that anywhere in your article. All your focus seems to be only on the “inflammatory cytokines produced as a response to them.” I thought that the spike proteins themselves directly cause clots to form because of their disturbing the free flow of blood along the inside of the walls of arteries and capillaries. Wouldn’t their presence restrict that free flow and cause increase in local pressure and create conditions for clotting?
The comment shows up when I approve it or reply to it. That mechanism is to prevent spam emails.
You say “The blood clots that caused the strokes came from the spike proteins …”; but I could not find where you explain how they do that anywhere in your article. All your focus seems to be only on the “inflammatory cytokines produced as a response to them.” I thought that the spike proteins themselves directly cause clots to form because of their disturbing the free flow of blood along the inside of the walls of arteries and capillaries. Wouldn’t their presence restrict that free flow and cause increase in local pressure and create conditions for clotting?
Hi Aaron! The inflammation and roughness in the inner lining of the blood vessels induced by the spike proteins elicits a repair process. The first part is a thrombus formation that begins with the platelets sticking to each other. Next the soluble fibrinogen becomes fibrin and form fibrin bridges that attracts more platelets and red blood cells. This causes the clot to become bigger and bigger until it occludes the arteries or the vein. The other possibility is that they break off and travel somewhere distal to the location and cause a blockage somewhere else. One publication that describes that is https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8397505/