Pomara Cristoforo, Salerno Monica, Esposito Massimiliano, Sessa Francesco, Certo Francesco, Tripodo Claudio, Rappa Francesca, Barbagallo Giuseppe Maria
Department of Medical, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, 95121 Catania, Italy.
Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy.
Pathol Res Pract. 2022 Mar;231:153796. doi: 10.1016/j.prp.2022.153796. Epub 2022 Feb 4.
This case report describes a fatal case of a young woman with superior sagittal, transverse and sigmoid sinus thrombosis after administration of the ChAdOx1 nCov-19 vaccination. Eleven days post-vaccination she was found unconscious and transferred to the Emergency Department. Blood parameters showed low platelets, and a CT scan showed an extensive left intracranial hemorrhage and the presence of an occlusive thrombus of the superior sagittal sinus. She under-went a craniectomy, but after the intervention, she remained in a comatose state. After a few days, her clinical conditions worsened, and she died. A complete autopsy was performed which showed a thrombosis of the cerebral venous district, of the upper and lower limbs. A blood sample was also performed to carry out a gene study about the predisposition to thrombosis. The organ samples were studied through light microscope both in hematoxylin-eosin and immunohistochemical examination, and showed a strong inflammatory response in all samples and at the site of thrombosis. Our study aims to provide a proper autopsy technique to study the entire cerebral venous system through a multidisciplinary approach (anatomical dissection and neurosurgery) in post-vaccine venous thrombosis.
本病例报告描述了一名年轻女性在接种ChAdOx1 nCov-19疫苗后发生上矢状窦、横窦和乙状窦血栓形成的致命病例。接种疫苗11天后，她被发现昏迷并被送往急诊科。血液参数显示血小板减少，CT扫描显示广泛的左侧颅内出血以及上矢状窦存在闭塞性血栓。她接受了开颅手术，但术后仍处于昏迷状态。几天后，她的临床状况恶化并死亡。进行了完整的尸检，结果显示脑静脉区、上肢和下肢存在血栓形成。还采集了血样进行关于血栓形成易感性的基因研究。通过苏木精-伊红染色和免疫组织化学检查，用光镜对器官样本进行了研究，结果显示所有样本以及血栓形成部位均有强烈的炎症反应。我们的研究旨在提供一种合适的尸检技术，通过多学科方法（解剖 dissection 和神经外科手术）研究疫苗接种后静脉血栓形成中的整个脑静脉系统。
