病例报告：再审视一下：与新冠病毒疫苗接种相关的脑静脉血栓形成和血栓性血小板减少综合征。

Braun Tobias, Viard Maxime, Juenemann Martin, Struffert Tobias, Schwarm Frank, Huttner Hagen B, Roessler Florian C

Department of Neurology, University Hospital Giessen, Giessen, Germany.

Department of Neuroradiology, University Hospital Giessen, Giessen, Germany.

Front Neurol. 2021 Nov 22;12:763049. doi: 10.3389/fneur.2021.763049. eCollection 2021.

We present two cases of ChAdOx1 nCov-19 (AstraZeneca)-associated thrombotic thrombocytopenia syndrome (TTS) and cerebral venous sinus thrombosis (CVST). At the time of emergency room presentation due to persistent headache, blood serum levels revealed reduced platelet counts. Yet, 1 or 4 days after the onset of the symptom, the first MR-angiography provided no evidence of CVST. Follow-up imaging, performed upon headache refractory to nonsteroidal pain medication verified CVST 2-10 days after initial negative MRI. Both the patients received combined treatment with intravenous immunoglobulins and parenteral anticoagulation leading to an increase of platelet concentration in both the individuals and resolution of the occluded cerebral sinus in one patient.

我们报告了两例与ChAdOx1 nCov-19（阿斯利康）相关的血栓性血小板减少综合征（TTS）和脑静脉窦血栓形成（CVST）病例。因持续性头痛到急诊室就诊时，血清水平显示血小板计数降低。然而，在症状出现后的1天或4天，首次磁共振血管造影未发现CVST的证据。在非甾体类止痛药治疗无效的头痛后进行的后续成像显示，在最初MRI阴性后的2 - 10天证实了CVST。两名患者均接受了静脉注射免疫球蛋白和胃肠外抗凝的联合治疗，导致两人的血小板浓度均升高，且其中一名患者的闭塞性脑窦得到缓解。