{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T10:20:48Z","timestamp":1790677248525,"version":"4.1.0"},"reference-count":29,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,8,23]],"date-time":"2021-08-23T00:00:00Z","timestamp":1629676800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Annals of Neurology"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We aimed to estimate the incidence of cerebral sinus and venous thrombosis (CVT) within 1 month from first dose administration and the frequency of vaccine\u2010induced immune thrombotic thrombocytopenia (VITT) as the underlying mechanism after vaccination with BNT162b2, ChAdOx1, and mRNA\u20101273, in Germany.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A web\u2010based questionnaire was e\u2010mailed to all departments of neurology. We requested a report of cases of CVT occurring within 1 month of a COVID\u201019 vaccination. Other cerebral events could also be reported. Incidence rates of CVT were calculated by using official statistics of 9 German states.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 45 CVT cases were reported. In addition, 9 primary ischemic strokes, 4 primary intracerebral hemorrhages, and 4 other neurological events were recorded. Of the CVT patients, 35 (77.8%) were female, and 36 (80.0%) were younger than 60\u2009years. Fifty\u2010three events were observed after vaccination with ChAdOx1 (85.5%), 9 after BNT162b2 (14.5%) vaccination, and none after mRNA\u20101273 vaccination. After 7,126,434 first vaccine doses, the incidence rate of CVT within 1 month from first dose administration was 0.55 (95% confidence interval [CI] =\u20090.38\u20130.78) per 100,000 person\u2010months (which corresponds to a risk of CVT within the first 31\u2009days of 0.55 per 100,000 individuals) for all vaccines and 1.52 (95% CI\u00a0=\u00a01.00\u20132.21) for ChAdOx1 (after 2,320,535 ChAdOx1 first doses). The adjusted incidence rate ratio was 9.68 (95% CI\u00a0=\u00a03.46\u201334.98) for ChAdOx1 compared to mRNA\u2010based vaccines and 3.14 (95% CI\u00a0=\u00a01.22\u201310.65) for females compared to non\u2010females. In 26 of 45 patients with CVT (57.8%), VITT was graded highly probable.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>Given an incidence of 0.02 to 0.15 per 100,000 person\u2010months for CVT in the general population, these findings point toward a higher risk for CVT after ChAdOx1 vaccination, especially for women. ANN NEUROL 2021;90:627\u2013639<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ana.26172","type":"journal-article","created":{"date-parts":[[2021,7,20]],"date-time":"2021-07-20T02:46:26Z","timestamp":1626749186000},"page":"627-639","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":120,"title":["<scp>COVID<\/scp>\n                    \u201019 Vaccine\u2010Associated Cerebral Venous Thrombosis in Germany"],"prefix":"10.1002","volume":"90","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8903-0593","authenticated-orcid":false,"given":"J\u00f6rg B.","family":"Schulz","sequence":"first","affiliation":[{"name":"Department of Neurology Rheinisch\u2010Westf\u00e4lische Techische Hochschule (RWTH) Aachen University  Aachen Germany"},{"name":"J\u00fclich Aachen Research Alliance (JARA)\u2010BRAIN Institute of Molecular Neuroscience and Neuroimaging, Research Center J\u00fclich and RWTH Aachen University  Aachen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Berlit","sequence":"additional","affiliation":[{"name":"German Society of Neurology  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans\u2010Christoph","family":"Diener","sequence":"additional","affiliation":[{"name":"Institute for Medical Informatics, Biometry and Epidemiology University of Duisburg\u2010Essen  Essen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Gerloff","sequence":"additional","affiliation":[{"name":"German Society of Neurology  Berlin Germany"},{"name":"Department of Neurology University Hospital Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Greinacher","sequence":"additional","affiliation":[{"name":"Department of Transfusion Medicine, Institute of Immunology and Transfusion Medicine University Medical Center Greifswald  Greifswald Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2102-3431","authenticated-orcid":false,"given":"Christine","family":"Klein","sequence":"additional","affiliation":[{"name":"German Society of Neurology  Berlin Germany"},{"name":"Institute of Neurogenetics, University of L\u00fcbeck and University Hospital of Schleswig\u2010Holstein  L\u00fcbeck Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabor C.","family":"Petzold","sequence":"additional","affiliation":[{"name":"Section of Vascular Neurology, Department of Neurology University Hospital Bonn  Bonn Germany"},{"name":"German Center for Neurodegenerative Diseases  Bonn Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Piccininni","sequence":"additional","affiliation":[{"name":"Institute of Public Health Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin  Berlin Germany"},{"name":"Center for Stroke Research Berlin Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0286-8781","authenticated-orcid":false,"given":"Sven","family":"Poli","sequence":"additional","affiliation":[{"name":"Department of Neurology &amp; 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