Abstract
Vaccine-induced immune thrombotic thrombocytopenia is a rare syndrome following the
ChAdOx1 nCov-19 or Ad26.COV2.S vaccine. Reported patients developed mainly venous
thrombosis. We describe a case of a young healthy women suffering from acute ischemic
stroke due to large vessel occlusion without cerebral venous thrombosis 8 days after
vaccination and its consequences on recanalization strategy.
Considering the thrombocytopenia, intravenous thrombolysis was contraindicated. She
underwent mechanical thrombectomy with complete recanalization and dramatically improved
clinically. Positive detection of anti-PF4-heparin-antibodies confirmed vaccine-induced
immune thrombotic thrombocytopenia diagnosis.
In case of acute ischemic stroke after recent ChAdOx1 nCov-19 or Ad26.COV2.S vaccine,
platelet count should be systematically checked before giving thrombolysis, and direct
mechanical thrombectomy should be proposed in patients with large vessel occlusion.
Key Words
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References
- Thrombotic thrombocytopenia after ChAdOx1 nCov-19 vaccination.N Engl J Med. 2021; 21: 04840
- Thrombosis and thrombocytopenia after ChAdOx1 nCoV-19 vaccination.N Engl J Med. 2021; 21: 04882
- Thrombotic thrombocytopenia after Ad26.COV2.S vaccination.N Engl J Med. 2021; 21: 05869
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Article info
Publication history
Published online: June 24, 2021
Accepted:
June 4,
2021
Received in revised form:
May 31,
2021
Received:
May 10,
2021
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2021.105942
Copyright
© 2021 Elsevier Inc. All rights reserved.
