McMillan Nadia, Rosenberg Harry J, Anderson Matthew P, Pal Pankaj, Stephenson Kathryn, Fehnel Corey R
Department of Neurology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Department of Pathology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Neurohospitalist. 2023 Apr;13(2):156-158. doi: 10.1177/19418744221136898. Epub 2022 Dec 5.
Venous thromboses have been linked to several COVID-19 vaccines, but there is limited information on the Moderna vaccine's effect on the risk of arterial thrombosis. Here we describe a case of post-Moderna COVID-19 vaccination arterial infarct with vaccine-associated diffuse cortical edema that was complicated by refractory intracranial hypertension.
24 hrs after receiving her first dose of the Moderna COVID-19 vaccine, a 30-year-old female developed severe headache. Three weeks later she was admitted with subacute headache and confusion. Imaging initially showed scattered cortical thrombosis with an elevated opening pressure on lumbar puncture. An external ventricular drain was placed, but she continued to have elevated intracranial pressure. Ultimately, she required a hemicraniectomy, but intractable cerebral edema resulted in her death. Pathology was consistent with thrombosis and associated inflammatory response.
Though correlational, her medical team surmised that the mRNA vaccine may have contributed to this presentation. The side effects of COVID-19 infection and vaccination are still incompletely understood. Though complications are rare, clinicians should be aware of presentations like this one.
静脉血栓形成与几种新冠疫苗有关，但关于莫德纳疫苗对动脉血栓形成风险的影响信息有限。在此，我们描述一例接种莫德纳新冠疫苗后发生动脉梗死并伴有疫苗相关弥漫性皮质水肿且并发难治性颅内高压的病例。
一名30岁女性在接种第一剂莫德纳新冠疫苗24小时后出现严重头痛。三周后，她因亚急性头痛和意识模糊入院。影像学检查最初显示散在的皮质血栓形成，腰椎穿刺时初压升高。放置了外置脑室引流管，但她的颅内压持续升高。最终，她需要进行颅骨切除术，但难治性脑水肿导致了她的死亡。病理检查结果与血栓形成及相关炎症反应一致。
尽管是相关性的，但她的医疗团队推测mRNA疫苗可能与这一情况有关。新冠病毒感染和疫苗接种的副作用仍未完全了解。尽管并发症罕见，但临床医生应警惕此类情况。
