Repeated Cardioembolic Stroke after COVID-19 mRNA Vaccination : A Case Report

Copyright © 2021 Elsevier Inc. All rights reserved..

OBJECTIVE: There have been no reports suggesting a relationship between the COVID-19 mRNA vaccines that encodes the spike glycoprotein of SARS-CoV-2 and cerebrovascular disease. A case of repeated cardioembolic stroke after vaccination with the BNT162b2 (Pfizer) COVID-19 mRNA vaccine is presented.

METHODS: Imaging and laboratory findings, treatment decisions, and the outcome of this case are presented.

RESULTS: An 83-year-old Japanese woman developed right hemiplegia and motor aphasia three days after receiving her first dose of the BNT162b2 (Pfizer) COVID-19 mRNA vaccine. She had been taking rivaroxaban for persistent atrial fibrillation for 10 years, but had no symptomatic ischemic strokes. On magnetic resonance imaging (MRI) the left middle cerebral artery (MCA) was occluded. Intravenous recombinant tissue-plasminogen activator (rt-PA) therapy and mechanical thrombectomy were performed, and she recovered almost fully. However, three days after the second dose, she developed left hemiplegia and left hemispatial neglect. MRI showed occlusion of the right MCA. Only mechanical thrombectomy was performed again, but it could not be resumed due to the hard thrombus.

DISCUSSION: In this case, it is difficult to exclude a causal relationship between the COVID-19 mRNA vaccine and ischemic stroke. This association needs to be carefully monitored.

Medienart:

E-Artikel

Erscheinungsjahr:

2022

Erschienen:

2022

Enthalten in:

Zur Gesamtaufnahme - volume:31

Enthalten in:

Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association - 31(2022), 2 vom: 01. Feb., Seite 106233

Sprache:

Englisch

Beteiligte Personen:

Yoshida, Kentaro [VerfasserIn]
Tanaka, Kenichiro [VerfasserIn]
Suto, Yutaka [VerfasserIn]
Fukuda, Hiroki [VerfasserIn]

Links:

Volltext

Themen:

BNT162 Vaccine
COVID-19
COVID-19 Vaccines
Case Reports
EC 3.4.21.68
Ischemic stroke
MRNA vaccine
N38TVC63NU
Recurrent stroke
Tissue Plasminogen Activator

Anmerkungen:

Date Completed 01.02.2022

Date Revised 21.12.2022

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1016/j.jstrokecerebrovasdis.2021.106233

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM334198763