Arterial thrombosis following first-dose ChAdOx1 vaccination: a case series

• Published in: BMJ neurology open Vol. 4; no. 1; p. e000270
• Main Authors: Chatterton, Sophie, Mason, George Albert, Cook, Raymond, Davidson, Keryn, Ward, Christopher, Ng, Karl
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group Ltd 01.05.2022; BMJ Publishing Group LTD; BMJ Publishing Group
• Subjects: Blood clots; Blood platelets; cerebrovascular disease; COVID-19; Extubation; Hemorrhage; Immunoassay; Immunoglobulins; Intracranial pressure; Ischemia; neuroimmunology; neurosurgery; Patients; Severe acute respiratory syndrome coronavirus 2; Sinuses; stroke; Thrombocytopenia; Thrombosis; Veins & arteries; Viewpoint; COVID-19; neuroimmunology; cerebrovascular disease; neurosurgery; stroke
• ISSN: 2632-6140; 2632-6140
• DOI: 10.1136/bmjno-2022-000270

A CT acute stroke protocol demonstrated an extensive left common carotid thrombus extending into the left internal carotid artery (ICA) with a large penumbra of the left middle cerebral artery territory. Functional VITT assays demonstrated mixed results with a positive serotonin release assay (SRA) but negative customised flow cytometry and Multiplate platelet aggregation tests. Significant platelet increment, rising fibrinogen and decreasing D-dimer levels were noted following IVIg (figure 3). Continued improvement ensued over several months, and at last follow-up 3 months after admission she was independently mobile but requiring some assistance from family members, exhibiting mild left-sided neglect and a hemianopia.