Cerebral Venous Sinus Thrombosis without Thrombotic Thrombocytopenic Syndrome in a Male Patient after Ad26.COV2.S Vaccination
Objective: Here we present one of the first cases of Janssen (Johnson & Johnson Ad26.COV2.S vaccine-associated cerebral venous sinus thrombosis (CVST) in a male patient, and the presumed first case without associated thrombotic thrombocytopenic syndrome (TTS). Method: Patient was identified as a vaccine-related adverse effect due to the unusual presentation of CVST in a male following COVID-19 vaccination, though without thrombocytopenia. Results: Patient presented with left-sided weakness and transient dysarthria. Imaging revealed extensive CVST. Thorough coagulopathy work-up was negative and platelet levels remained within the normal range. Patient improved with non-heparin anticoagulation. Discussion: As more people worldwide continue to be vaccinated against COVID-19, the incidence of vaccine-related complications can be expected to rise. Multiple cases of CVST have been reported in patients following COVID-19 vaccination with associated TTS, nearly all in women. However, this is not the only presentation. Cerebral venous sinus thrombosis should be a consideration in patients who present with headache or altered mental status after COVID vaccination, despite normal platelet levels.
Heuvelhorst KL, Diener T, Manzoor H, Khadra M, Musa F, Jafri SK. Cerebral venous sinus thrombosis without thrombotic thrombocytopenic syndrome in a male patient after Ad26. COV2. S vaccination. American Journal of Medical Case Reports. 2021;9(12):719-21.