Finsterer Josef
Klinik Landstrasse, Messerli Institute, Vienna, Austria.
Brain Hemorrhages. 2022 Mar;3(1):26-28. doi: 10.1016/j.hest.2021.10.001. Epub 2021 Oct 28.
Vaccination against SARS-CoV-2 is beneficial but may be rarely accompanied by side effects. We report a 67yo female who developed visual impairment, dysarthria, confusion, and fatigue a few hours after a first dosage with an mRNA-based SARS-CoV-2 vaccine (Pfizer). Her previous history listed diabetes, arterial hypertension, arterial occlusive disease, a single renal cyst on the left side, smoking, and ischemic stroke 20y earlier. Stroke was complicated by normal pressure hydrocephalus requiring placement of a ventriculo-atrial (VA)-shunt. Cerebral imaging revealed a right-sided intracerebral bleeding with ventricular rupture and correct placement of the VA-shunt. Neurosurgeons decided against surgical treatment. The further course was dominated by prolonged confusion, visual impairment, and disorientation but ultimately only minor deficits. In conclusion, a single patient experienced intracerebral bleeding with ventricular rupture shortly after application of the first jab of an mRNA-based SARS-CoV-2 vaccine. Whether bleeding was causally related to the vaccination or occurred coincidentally, remains speculative.
接种新冠病毒疫苗有益，但可能很少伴有副作用。我们报告了一名67岁女性，在首次接种基于mRNA的新冠病毒疫苗（辉瑞）几小时后出现视力障碍、构音障碍、意识模糊和疲劳。她既往有糖尿病、动脉高血压、动脉闭塞性疾病、左侧单个肾囊肿、吸烟史，20年前有缺血性中风。中风并发正常压力脑积水，需要放置脑室-心房（VA）分流管。脑部影像学检查显示右侧脑内出血伴脑室破裂，VA分流管放置正确。神经外科医生决定不进行手术治疗。后续病程以长期意识模糊、视力障碍和定向障碍为主，但最终仅有轻微缺陷。总之，一名患者在接种第一剂基于mRNA的新冠病毒疫苗后不久出现脑内出血伴脑室破裂。出血是否与疫苗接种有因果关系或只是巧合，仍属推测。
