Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 16, 2022; 10(26): 9462-9469
Published online Sep 16, 2022. doi: 10.12998/wjcc.v10.i26.9462
Rapid progressive vaccine-induced immune thrombotic thrombocytopenia with cerebral venous thrombosis after ChAdOx1 nCoV-19 (AZD1222) vaccination: A case report
Shin-Kuang Jiang, Wei-Liang Chen, Chun Chien, Chi-Syuan Pan, Sheng-Ta Tsai
Shin-Kuang Jiang, Sheng-Ta Tsai, Department of Neurology, China Medical University Hospital, Taichung 404332, Taiwan
Wei-Liang Chen, Department of Radiology, China Medical University Hospital, Taichung 404332, Taiwan
Chun Chien, Department of Neurology, China Medical University Hsinchu Hospital, Hsinchu 30272, Taiwan
Chi-Syuan Pan, Department of Emergency, China Medical University Hospital, Taichung 404332, Taiwan
Sheng-Ta Tsai, Neuroscience and Brain Disease Center, China Medical University, Taichung 404332, Taiwan
Author contributions: Jiang SK and Tsai ST were the patient’s chief attending doctor during hospitalization, collected the patient‘s clinical data, reviewed the literature, and contributed to manuscript drafting; Jiang SK drafted the manuscript; Pan CS was the doctor in emergency department who evaluated her first and was alert to this syndrome; Chien C reviewed the literature and contributed to manuscript drafting; Chen WL analyzed and interpreted the imaging findings and he was consulted for endovascular therapy; Tsai ST was responsible for the revision of the manuscript for important intellectual content; and All authors issued final approval for the version to be submitted.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying image.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016) and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Sheng-Ta Tsai, MD, PhD, Attending Doctor, Department of Neurology, China Medical University Hospital, No. 2 Yude Road, North District, Taichung 404332, Taiwan.
Received: April 26, 2022
Peer-review started: April 26, 2022
First decision: June 8, 2022
Revised: June 20, 2022
Accepted: August 1, 2022
Article in press: August 1, 2022
Published online: September 16, 2022
Core Tip

Core Tip: Vaccine-induced immune thrombotic thrombocytopenia (VITT) is a rare and potentially life-threatening condition. Only few studies have described the detailed clinical course and imaging changes in patients with VITT. We report a typical case of VITT in a patient presenting with headaches 7 d postvaccination with progressive left upper limb clumsiness. A series of brain imaging examinations revealed venous infarction, which can progress very fast. Our case demonstrated that VITT diagnosis can be delayed. Clinicians should be alerted whenever a patient with a persistent and progressive headaches or focal motor/sensory deficits after vaccination also presents with high D-dimer level and thrombocytopenia.