The coronavirus disease-2019 (COVID-19) pandemic has been a major threat to global health. It primarily affects the respiratory system but multiple organs, including the nervous system, can be affected. Cerebral venous thrombosis (CVT) has been reported among COVID-19 patients as well as among recipients of COVID vaccines. CVT often remains a diagnostic challenge due to highly variable clinical presentation. We underwent a thorough narrative review of the published literature from January 2020 to April 2023 in the Medline (PubMed) database. Our search led to 66 studies in total, 30 related to COVID-CVT and 36 related to COVID vaccine-CVT. We further looked for differences between these COVID-CVT and COVID vaccine-associated-CVT and their possible pathophysiology, treatment options, and prognosis. A few things that were highlighted during our search: COVID increases CVT risk and can happen without respiratory manifestations. COVID-CVT is more common in middle-aged men and has a higher morality compared to traditional non-COVID-CVT. COVID vaccines also increase the risk of CVT but less than the COVID infection. COVID vaccine-CVT is further divided into two groups having either normal platelets or low platelets. The latter group is better reported and has a higher inpatient mortality and disability at discharge but these patients usually recover well in the follow-up period. Non-heparin anticoagulation, immunomodulation, and surgery are the main treatment options.
Johns Hopkins University Coronavirus Resource Center. https://coronavirus.jhu.edu/
2.
RománGC, SpencerPS, *ReisJ, . The neurology of COVID-19 revisited: a proposal from the environmental neurology specialty group of the world federation of neurology to implement international neurological registries. J Neurol Sci. 2020;414:116884. https://doi.org/10.1016/j.jns.2020.116884
3.
WasayM, KaulS, *MenonB, . Asian study of cerebral venous thrombosis. J Stroke Cerebrovasc Dis. 2019;28:104247. https://doi.org/10.1016/j.jstrokecerebrovasdis.2019.06.005
4.
DentaliF, PoliD, *ScodittiU, . Long‐term outcomes of patients with cerebral vein thrombosis: A multicenter study. J Thromb Haemost. 2012;10:1297–1302. https://doi.org/10.1111/j.1538-7836.2012.04774.x
5.
FerroJM, CanhãoP, StamJ, BousserMG, *BarinagarrementeriaF.Prognosis of cerebral vein and dural sinus thrombosis: Results of the international study on cerebral vein and dural sinus thrombosis (ISCVT). Stroke. 2004;35:664–670. https://doi.org/10.1161/01.STR.0000117571.76197.26
6.
CoutinhoJM, ZuurbierSM, AramidehM, *StamJ.The incidence of cerebral venous thrombosis: A cross-sectional study. Stroke. 2012;43(12):3375–3377. https://doi.org/10.1161/STROKEAHA.112.671453
7.
DevasagayamS, WyattB, LeydenJ, *KleinigT.Cerebral venous sinus thrombosis incidence is higher than previously thought: A retrospective population-based study. Stroke. 2016; 47(9): 2180–2182. https://doi.org/10.1161/STROKEAHA.116.013617
8.
KristoffersenES, HarperCE, VetvikKG, ZarnovickyS, HansenJM, *FaizKW.Incidence and mortality of cerebral venous thrombosis in a Norwegian population. Stroke. 2020;51(10):3023–3029. https://doi.org/10.1161/STROKEAHA.120.030800
9.
HameedS, WasayM, *SoomroBA, . Cerebral venous thrombosis associated with COVID-19 infection: an observational, multicenter study. Cerebrovasc Dis Extra. 2021;11:55–60. https://doi.org/10.1159/000516641
MowlaA, ShakibajahromiB, *ShahjoueiS, . Cerebral venous sinus thrombosis associated with SARS-CoV-2: A multinational case series. J Neurol Sci. 2020;419:117183. https://doi.org/10.1016/j.jns.2020.117183.
12.
CavalcantiDD, RazE, *ShapiroM, . Cerebral venous thrombosis associated with COVID-19. AJNR Am J Neuroradiol. 2020;41:1370–1376. https://doi.org/10.3174/ajnr.A6644.
13.
PoillonG, ObadiaM, PerrinM, SavatovskyJ, *LeclerA.Cerebral venous thrombosis associated with COVID-19 infection: Causality or coincidence?. J Neuroradiol. 2021;48:121–124. https://doi.org/10.1016/j.neurad.2020.05.003
14.
SieglerJE, CardonaP, *ArenillasJF, . Cerebrovascular events and outcomes in hospitalized patients with COVID-19: The SVIN COVID-19 multinational registry. Int J Stroke. 2021;16:437–447. https://doi.org/10.1177/1747493020959216
15.
KleinDE, LibmanR, KirschC, *AroraR.Cerebral venous thrombosis: A typical presentation of COVID-19 in the young. J Stroke Cerebrovasc Dis. 2020;29:104989. https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.104989
16.
BaudarC, DuprezT, KassabA, MillerN, *RutgersMP.COVID-19 as triggering co-factor for cortical cerebral venous thrombosis?. J Neuroradiol. 2021;48:65–67. https://doi.org/10.1016/j.neurad.2020.06.008
17.
RigamontiA, ManteroV, PiamartaF, SpenaG, *SalmaggiA.Cerebral venous thrombosis associated with coronavirus infection: An underestimated entity?. Neurol Sci. 2021;42:317–318. https://doi.org/10.1007/s10072-020-04539-7
18.
TaquetM, HusainM, GeddesJR, LucianoS, *HarrisonPJ.Cerebral venous thrombosis and portal vein thrombosis: A retrospective cohort study of 537,913 COVID-19 cases. EClinicalMedicine. 2021;39:101061. https://doi.org/10.1016/j.eclinm.2021.101061
19.
KlokFA, KruipMJ, *Van der MeerNJ, . Confirmation of the high cumulative incidence of thrombotic complications in critically ill ICU patients with COVID-19: An updated analysis. Thromb Res. 2020;191:148–150. https://doi.org/10.1016/j.thromres.2020.04.041
20.
LodigianiC, IapichinoG, *CarenzoL, . Venous and arterial thromboembolic complications in COVID-19 patients admitted to an academic hospital in Milan, Italy. Thromb Res. 2020;191:9–14. https://doi.org/10.1016/j.thromres.2020.04.024
21.
PoissyJ, GoutayJ, *CaplanM, . Pulmonary embolism in patients with COVID-19: awareness of an increased prevalence. Circulation. 2020;142:184–186. https://doi.org/10.1161/CIRCULATIONAHA.120.047430
22.
HanffTC, MoharebAM, GiriJ, CohenJB, *ChirinosJA.Thrombosis in COVID‐19. Am J Hematol. 2020;95:1578–1589. https://doi.org/10.1002/ajh.25982
23.
SchultzNH, SørvollIH, *MichelsenAE, . Thrombosis and thrombocytopenia after ChAdOx1 nCoV-19 vaccination. N Engl J Med. 2021;384:2124–2130. https://doi.org/10.1056/NEJMoa2104882
24.
SeeI, SuJR, *LaleA, . US case reports of cerebral venous sinus thrombosis with thrombocytopenia after Ad26. COV2. S vaccination, March 2 to April 21, 2021. JAMA. 2021;325:2448–2456. https://doi.org/10.1001/jama.2021.7517
25.
GreinacherA, ThieleT, WarkentinTE, WeisserK, KyrlePA, *EichingerS.Thrombotic thrombocytopenia after ChAdOx1 nCov-19 vaccination. N Engl J Med. 2021;384:2092–2101. https://doi.org/10.1056/NEJMoa2104840
TorjesenI.Covid-19: risk of cerebral blood clots from disease is 10 times that from vaccination, study finds. BMJ. 2021;373:n1005. https://doi.org/10.1136/bmj.n1005
28.
HemasianH, *AnsariB.First case of Covid-19 presented with cerebral venous thrombosis: A rare and dreaded case. Rev Neurol (Paris). 2020;176:521–523. https://doi.org/10.1016/j.neurol.2020.04.013
29.
BolajiP, KukoyiB, AhmadN, *WhartonC.Extensive cerebral venous sinus thrombosis: A potential complication in a patient with COVID-19 disease. BMJ Case Rep. 2020;13:e236820. https://doi.org/10.1136/bcr-2020-236820
30.
ChougarL, MathonB, WeissN, DegosV, *ShorN.Atypical deep cerebral vein thrombosis with hemorrhagic venous infarction in a patient positive for COVID-19. AJNR Am J Neuroradiol. 2020;41:1377–1379. https://doi.org/10.3174/ajnr.A6642
31.
CardosoER, BainsSS, RobisonB, *FarkasJ.Superficial cerebral venous thrombosis and intracerebral Hematoma in a 48-year-old man with SARS-CoV-2 infection: a case report. Am J Case Rep. 2021;22:e927011. https://doi.org/10.12659/AJCR.927011
32.
KananehMF, ThomasT, *SharmaK, . Arterial and venous strokes in the setting of COVID-19. J Clin Neurosci. 2020;79:60–66. https://doi.org/10.1016/j.jocn.2020.07.005
33.
SugiyamaY, TsuchiyaT, *TanakaR, . Cerebral venous thrombosis in COVID-19-associated coagulopathy: A case report. J Clin Neurosci. 2020;79:30–32. https://doi.org/10.1016/j.jocn.2020.07.038
34.
PangYZ, ShafiH, LeeZC, TingSK, *De SilvaDA.Cerebral venous thrombosis in a patient with mild COVID-19 infection. Ann Acad Med Singap. 2021;50(2):188–190. https://doi.org/10.47102/annals-acadmedsg.2020435.
35.
FarzinFJ, LasferC, *KambalI.Extensive cerebral venous thrombosis as an isolated presentation in a COVID-19-positive young adult. Cureus. 2022;14(9):e29561. https://doi.org/10.7759/cureus.29561
36.
TjahjadiM, CaropebokaS, PermanaC, SusantoK, *SusantoE.Long-delayed manifestation of COVID-19 coagulopathy presenting with severe cerebral venous thrombosis causes massive brain hemorrhage. Asian J Neurosurg. 2022;17(2):342–346. https://doi.org/10.1055/s-0042-1750388
37.
DiasR, Dos ReisRS, de SousaSP, RochaAF, RibeiroAM, *AlmeidaJ.Cerebral venous thrombosis in a young asymptomatic COVID-19 patient. Porto Biomed J. 2022;7(4):e165. https://doi.org/10.1097/j.pbj.0000000000000165
38.
TuTM, GohC, *TanYK, . Cerebral venous thrombosis in patients with COVID-19 infection: A case series and systematic review. J Stroke Cerebrovasc Dis. 2020;29:105379. https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.105379.
39.
NwajeiF, AnandP, *AbdalkaderM, . Cerebral venous sinus thromboses in patients with SARS-CoV-2 infection: Three cases and a review of the literature. J Stroke Cerebrovasc Dis. 2020;29:105412. https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.105412
40.
TuTM, YiSJ, KohJS et.al.Incidence of cerebral venous thrombosis following SARS-CoV-2 infection vs mRNA SARS-CoV-2 vaccination in Singapore. JAMA Netw Open. 2022;5(3):e222940. https://doi.org/10.1001/jamanetworkopen.2022.2940
41.
AbdalkaderM, ShaikhSP, *SieglerJE, . Cerebral venous sinus thrombosis in COVID-19 patients: A multicenter study and review of literature. J Stroke Cerebrovasc Dis. 2021;30:105733. https://doi.org/10.1016/j.jstrokecerebrovasdis.2021.105733
42.
Al-MuftiF, AmuluruK, *SahniR, . Cerebral venous thrombosis in COVID-19: A New York metropolitan cohort study. AJNR Am J Neuroradiol. 2021;42:1196–1200. https://doi.org/10.3174/ajnr.A7134
43.
KohJS, De SilvaDA, *QuekAM, . Neurology of COVID-19 in Singapore. J Neurol Sci. 2020;418:117118. https://doi.org/10.1016/j.jns.2020.117118
44.
OstovanVR, ForoughiR, *RostamiM, . Cerebral venous sinus thrombosis associated with COVID-19: A case series and literature review. J Neurol. 2021;268:3549–3560. https://doi.org/10.1007/s00415-021-10450-8
45.
WasayM, KhanM, *RajputHM, . New oral anticoagulants versus warfarin for cerebral venous thrombosis: a multi-center, observational study. J Stroke. 2019;21:220–223. https://doi.org/10.5853/jos.2019.00150
46.
HameedS, HamzaA, TaimuriB, KhanM, MehndirattaMM, *WasayM.Comparative study of cerebral venous thrombosis-risk factors, clinical course and outcome in subjects with and without Covid-19 infection. Cerebrovasc Dis Extra. 2023;13(1):63–68. https://doi.org/10.1159/000530819
MiddeldorpS, CoppensM, *van HaapsTF, . Incidence of venous thromboembolism in hospitalized patients with COVID‐19. J Thromb Haemost. 2020;18:1995–2002. https://doi.org/10.1111/jth.14888
49.
WallsAC, ParkYJ, TortoriciMA, WallA, McGuireAT, *VeeslerD.Structure, function, and antigenicity of the SARS-CoV-2 spike glycoprotein. Cell. 2020;181:281–292. e6. https://doi.org/10.1016/j.cell.2020.02.058
50.
HammingI, TimensW, BulthuisML, LelyAT, NavisGV, *van GoorH.Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus. A first step in understanding SARS pathogenesis. J Pathol. 2004;203:631–637. https://doi.org/10.1002/path.1570
51.
NadarS, *LipGY.The prothrombotic state in hypertension and the effects of antihypertensive treatment. Curr Pharm Des. 2003;9:1715–1732. https://doi.org/10.2174/1381612033454559
52.
GarciaD, *ErkanD.Diagnosis and management of the antiphospholipid syndrome. N Engl J Med. 2018;378:2010–2021. https://doi.org/10.1056/NEJMra1705454
53.
TanYK, GohC, *LeowAS, . COVID-19 and ischemic stroke: A systematic review and meta-summary of the literature. J Thromb Thrombolysis. 2020;50:587–595. https://doi.org/10.1007/s11239-020-02228-y
54.
XiaoM, ZhangY, *ZhangS, . Antiphospholipid antibodies in critically Ill patients with COVID‐19. Arthritis Rheumatol. 2020;72:1998–2004. https://doi.org/10.1002/art.41425
55.
BorghiMO, BeltagyA, *GarrafaE, . Anti-phospholipid antibodies in COVID-19 are different from those detectable in the anti-phospholipid syndrome. Front Immunol. 2020;11:584241. https://doi.org/10.3389/fimmu.2020.584241
56.
PottegårdA, LundLC, *ØKarlstad, . Arterial events, venous thromboembolism, thrombocytopenia, and bleeding after vaccination with Oxford-AstraZeneca ChAdOx1-S in Denmark and Norway: Population based cohort study. BMJ. 2021;373:n1114. https://doi.org/10.1136/bmj.n1114
57.
Hippisley-CoxJ, PatoneM, *MeiXW, . Risk of thrombocytopenia and thromboembolism after covid-19 vaccination and SARS-CoV-2 positive testing: Self-controlled case series study. BMJ. 2021;374:n1931. https://doi.org/10.1136/bmj.n1931
58.
AshraniAA, CrusanDJ, PettersonT, BaileyK, *HeitJA.Age-and sex-specific incidence of cerebral venous sinus thrombosis associated with Ad26. COV2. S COVID-19 vaccination. JAMA Intern Med. 2021:e216352. https://doi.org/10.1001/jamainternmed.2021.6352
59.
OhaeriC, ThomasDR, *SalmonJ, . Comparative risk of cerebral venous sinus thrombosis (CVST) following COVID-19 vaccination or infection: a national cohort study using linked electronic health records. Hum Vaccin Immunother. 2022;18(6):2127572. https://doi.org/10.1080/21645515.2022.2127572
60.
García-AzorínD, DoTP, *GantenbeinAR, . Delayed headache after COVID-19 vaccination: A red flag for vaccine induced cerebral venous thrombosis. J Headache Pain. 2021;22:108. https://doi.org/10.1186/s10194-021-01324-5.
HameedS, KhanAF, KhanS, *WasayM.First report of cerebral venous thrombosis following inactivated-virus covid vaccination (Sinopharm and Sinovac). J Stroke Cerebrovasc Dis. 2022;31(3):106298. https://doi.org/10.1016/j.jstrokecerebrovasdis.2021.106298
65.
HoviP, PalmuAA, *NieminenTA, . Incidence of sinus thrombosis with thrombocytopenia—A nation-wide register study. PLoS One. 2023;18(2):e0282226. https://doi.org/10.1371/journal.pone.0282226
66.
van de MunckhofA, Borhani-HaghighiA, *AaronS, . Cerebral venous sinus thrombosis due to vaccine-induced immune thrombotic thrombocytopenia in middle-income countries. Int J Stroke. 2023:17474930231182901. https://doi.org/10.1177/17474930231182901
67.
KatariaS, RezaRR, *AgboolaAA, . Immune thrombocytopenia and cerebral venous sinus thrombosis following COVID-19 vaccination: A case report. Cureus. 2023;15(1):e34272. https://doi.org/10.7759/cureus.34272
68.
ScutelnicA, van de MunckhofA, *KrzywickaK, . Sex differences in cerebral venous sinus thrombosis after adenoviral vaccination against COVID-19. Eur Stroke J. 2023:23969873231185213. https://doi.org/10.1177/23969873231185213
69.
SimpsonCR, KerrS, *KatikireddiSV, . Second-dose ChAdOx1 and BNT162b2 COVID-19 vaccines and thrombocytopenic, thromboembolic and hemorrhagic events in Scotland. Nat Commun. 2022;13(1):4800. https://doi.org/10.1038/s41467-022-32264-6
70.
ScullyM, SinghD, *LownR, . Pathologic antibodies to platelet factor 4 after ChAdOx1 nCoV-19 vaccination. N Engl J Med. 2021;384:2202–2211. https://doi.org/10.1056/NEJMoa2105385
71.
SorensenALT, RollandM, *HartmannJ, . A case of thrombocytopenia and multiple thromboses after vaccination with ChAdOx1 nCoV-19 against SARS-CoV-2. Blood Adv. 2021;5:2569–2574. https://doi.org/10.1182/bloodadvances.2021004904
72.
DuttaA, GhoshR, *BhattacharyaD, . Anti-PF4 antibody negative cerebral venous sinus thrombosis without thrombocytopenia following immunization with COVID-19 vaccine in an elderly non-comorbid Indian male, managed with conventional heparin-warfarin based anticoagulation. Diabetes Metab Syndr. 2021;15:102184. https://doi.org/10.1016/j.dsx.2021.06.021
73.
SureshP, *PetcheyW.ChAdOx1 nCOV-19 vaccine-induced immune thrombotic thrombocytopenia and cerebral venous sinus thrombosis (CVST). BMJ Case Rep. 2021;14:e243931. https://doi.org/10.1136/bcr-2021-243931
74.
CastelliGP, PognaniC, SozziC, FranchiniM, *VivonaL.Cerebral venous sinus thrombosis associated with thrombocytopenia post-vaccination for COVID-19. Crit Care. 2021;25:137. https://doi.org/10.1186/s13054-021-03572-y
75.
Van KammenMS, De SousaDA, *PoliS, . Characteristics and outcomes of patients with cerebral venous sinus thrombosis in SARS-CoV-2 vaccine–induced immune thrombotic thrombocytopenia. JAMA Neurol. 2021;78:1314–1323. https://doi.org/10.1001/jamaneurol.2021.3619
76.
van KammenMS, HeldnerMR, *BrodardJ, . Frequency of thrombocytopenia and platelet factor 4/heparin antibodies in patients with cerebral venous sinus thrombosis prior to the COVID-19 pandemic. JAMA2021;326(4):332–338. https://doi.org/10.1001/jama.2021.9889
77.
PerryRJ, TamborskaA, *SinghB, . Cerebral venous thrombosis after vaccination against COVID-19 in the UK: A multicentre cohort study. Lancet. 2021:S0140-6736(21)01608-1. https://doi.org/10.1016/S0140-6736(21)01608-1
78.
SchulzJB, BerlitP, *DienerHC, . COVID-19 vaccine-associated cerebral venous thrombosis in Germany. Ann Neurol. 2021;10.1002/ana.26172. https://doi.org/10.1002/ana.26172
79.
RizkJG, GuptaA, *SardarP, . Clinical characteristics and pharmacological management of COVID-19 vaccine–induced immune thrombotic thrombocytopenia with cerebral venous sinus thrombosis: a review. JAMA Cardiol. 2021;6(12):1451–1460. https://doi.org/10.1001/jamacardio.2021.3444
80.
BourguignonA, ArnoldDM, *WarkentinTE, . Adjunct immune globulin for vaccine-induced immune thrombotic thrombocytopenia. N Engl J Med2021;385(8):720–728. https://doi.org/10.1056/NEJMoa2107051
81.
DanielGW, MenisM, *SridharG, . Immune globulins and thrombotic adverse events as recorded in a large administrative database in 2008 through 2010. Transfusion. 2012;52(10):2113–2121. https://doi.org/10.1111/j.1537-2995.2012.03589.x
82.
ScutelnicA, KrzywickaK, *MbrohJ, . Management of cerebral venous thrombosis due to adenoviral COVID‐19 vaccination. Ann Neurol. 2022;92(4):562–573. https://doi.org/10.1002/ana.26431
PelzJO, KendaM, *AlonsoA, . Outcomes after decompressive surgery for severe cerebral venous sinus thrombosis associated or not associated with vaccine-induced immune thrombosis with thrombocytopenia: a multicenter cohort study. Neurocrit Care. 2023. https://doi.org/10.1007/s12028-023-01782-6
85.
KrzywickaK, Aguiar de SousaD, *CordonnierC, . Decompressive surgery in cerebral venous sinus thrombosis due to vaccine‐induced immune thrombotic thrombocytopenia. Eur J Neurol. 2023;30(5):1335–1345. https://doi.org/10.1111/ene.15735
86.
CleaverJ, IbitoyeR, *MorrisonH, . Endovascular treatment for vaccine-induced cerebral venous sinus thrombosis and thrombocytopenia following ChAdOx1 nCoV-19 vaccination: A report of three cases. J Neurointerv Surg. 2022;14(9):853–857. https://doi.org/10.1136/neurintsurg-2021-018238
87.
ChungY, RyuJ, *ChoiSK.Surgical thrombectomy for extensive cerebral venous sinus thrombosis after COVID-19 vaccination: a novel surgical technique and literature review. J Korean Neurosurg Soc. 2023. https://doi.org/10.3340/jkns.2023.0026
RameshSV, RameshPV, RameshMK, PadmanabhanV, *RajasekaranR.COVID-19-associated papilledema secondary to cerebral venous thrombosis in a young patient. Indian J Ophthalmol. 2021;69:770–772. https://doi.org/10.4103/ijo.IJO_2660_20
91.
DakayK, CooperJ, *BloomfieldJ, . Cerebral venous sinus thrombosis in COVID-19 infection: A case series and review of the literature. J Stroke Cerebrovasc Dis. 2021;30:105434. https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.105434
92.
GuendouzC, QuenardelleV, *Riou-ComteN, . Pathogeny of cerebral venous thrombosis in SARS-Cov-2 infection. Medicine (Baltimore). 2021;100:e24708. https://doi.org/10.1097/MD.0000000000024708
93.
KohJS, HoeRH, *YongMH, . Hospital-based observational study of neurological disorders in patients recently vaccinated with COVID-19 mRNA vaccines. J Neurol Sci. 2021;430:120030. https://doi.org/10.1016/j.jns.2021.120030
94.
DuttaA, GhoshR, *BhattacharyaD, . Anti-PF4 antibody negative cerebral venous sinus thrombosis without thrombocytopenia following immunization with COVID-19 vaccine in an elderly non-comorbid Indian male, managed with conventional heparin-warfarin based anticoagulation. Diabetes Metab Syndr. 2021;15:102184. https://doi.org/10.1016/j.dsx.2021.06.021
95.
GrafT, ThieleT, KlingebielR, GreinacherA, SchäbitzWR, *GreeveI.Immediate high-dose intravenous immunoglobulins followed by direct thrombin-inhibitor treatment is crucial for survival in Sars-Covid-19-adenoviral vector vaccine-induced immune thrombotic thrombocytopenia VITT with cerebral sinus venous and portal vein thrombosis. J Neurol. 2021;268(12):4483–4485. https://doi.org/10.1007/s00415-021-10599-2
96.
SyedK, ChaudharyH, *DonatoA.Central venous sinus thrombosis with subarachnoid hemorrhage following an mRNA COVID-19 vaccination: are these reports merely co-incidental?. Am J Case Rep. 2021;22:e933397. https://doi.org/10.12659/AJCR.933397
97.
MaramattomBV, MoiduFM, VarikkottilS, *SyedAA.Cerebral venous sinus thrombosis after ChAdOx1 vaccination: The first case of definite thrombosis with thrombocytopenia syndrome from India. BMJ Case Rep. 2021;14(10):e246455. https://doi.org/10.1136/bcr-2021-246455
98.
ClarkRT, JohnsonL, *BillottiJ, . Early outcomes of bivalirudin therapy for thrombotic thrombocytopenia and cerebral venous sinus thrombosis after Ad26. COV2. S vaccination. Ann Emerg Med. 2021:511–514. https://doi.org/10.1016/j.annemergmed.2021.04.035
99.
CeschiaN, ScheggiV, *GoriAM, . Diffuse prothrombotic syndrome after ChAdOx1 nCoV-19 vaccine administration: A case report. J Med Case Rep. 2021;15:496. https://doi.org/10.1186/s13256-021-03083-y
100.
ChoiJK, KimS, *KimSR, . Intracerebral hemorrhage due to thrombosis with thrombocytopenia syndrome after vaccination against COVID-19: The first fatal case in Korea. J Korean Med Sci. 2021;36(31):e223. https://doi.org/10.3346/jkms.2021.36.e223
101.
GuanCY, TsaiSH, FanJS, LinYK, *KaoCC.Middle-age Asian male with cerebral venous thrombosis after COVID-19 AstraZeneca vaccination. Am J Emerg Med. 2022;51:427.e3–427.e4. https://doi.org/10.1016/j.ajem.2021.07.011
102.
AladdinY, AlgahtaniH, *ShirahB.Vaccine-induced immune thrombotic thrombocytopenia with disseminated intravascular coagulation and death following the ChAdOx1 nCoV-19 vaccine. J Stroke Cerebrovasc Dis. 2021;30(9):105938. https://doi.org/10.1016/j.jstrokecerebrovasdis.2021.105938
103.
BersingerS, LagardeK, MarluR, PernodG, *PayenJF.Using nonheparin anticoagulant to treat a near-fatal case with multiple venous thrombotic lesions during ChAdOx1 nCoV-19 vaccination-related vaccine-induced immune thrombotic thrombocytopenia. Crit Care Med. 2021;49(9):e870–e873. https://doi.org/10.1097/CCM.0000000000005105
EsbaLCA, *Al JeraisyM.Reported adverse effects following COVID-19 vaccination at a tertiary care hospital, focus on cerebral venous sinus thrombosis (CVST). Expert Rev Vaccines. 2021;20(8):1037–1042. https://doi.org/10.1080/14760584.2021.1940145
