{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T10:16:58Z","timestamp":1773483418199,"version":"3.50.1"},"reference-count":26,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,7,4]],"date-time":"2022-07-04T00:00:00Z","timestamp":1656892800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001826","name":"ZonMw","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Annals of Neurology"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Cerebral venous thrombosis (CVT) caused by vaccine\u2010induced immune thrombotic thrombocytopenia (VITT) is a rare adverse effect of adenovirus\u2010based severe acute respiratory syndrome\u2010coronavirus 2 (SARS\u2010CoV\u20102) vaccines. In March 2021, after autoimmune pathogenesis of VITT was discovered, treatment recommendations were developed. These comprised immunomodulation, non\u2010heparin anticoagulants, and avoidance of platelet transfusion. The aim of this study was to evaluate adherence to these recommendations and its association with mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We used data from an international prospective registry of patients with CVT after the adenovirus\u2010based SARS\u2010CoV\u20102 vaccination. We analyzed possible, probable, or definite VITT\u2010CVT cases included until January 18, 2022. Immunomodulation entailed administration of intravenous immunoglobulins and\/or plasmapheresis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Ninety\u2010nine patients with VITT\u2010CVT from 71 hospitals in 17 countries were analyzed. Five of 38 (13%), 11 of 24 (46%), and 28 of 37 (76%) of the patients diagnosed in March, April, and from May onward, respectively, were treated in\u2010line with VITT recommendations (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Overall, treatment according to recommendations had no statistically significant influence on mortality (14\/44 [32%] vs 29\/55 [52%], adjusted odds ratio [OR]\u00a0=\u00a00.43, 95% confidence interval [CI]\u00a0=\u00a00.16\u20131.19). However, patients who received immunomodulation had lower mortality (19\/65 [29%] vs 24\/34 [70%], adjusted OR\u00a0=\u00a00.19, 95% CI\u00a0=\u00a00.06\u20130.58). Treatment with non\u2010heparin anticoagulants instead of heparins was not associated with lower mortality (17\/51 [33%] vs 13\/35 [37%], adjusted OR\u00a0=\u00a00.70, 95% CI\u00a0=\u00a00.24\u20132.04). Mortality was also not significantly influenced by platelet transfusion (17\/27 [63%] vs 26\/72 [36%], adjusted OR\u00a0=\u00a02.19, 95% CI\u00a0=\u00a00.74\u20136.54).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In patients with VITT\u2010CVT, adherence to VITT treatment recommendations improved over time. Immunomodulation seems crucial for reducing mortality of VITT\u2010CVT. ANN NEUROL 2022;92:562\u2013573<\/jats:p><\/jats:sec>","DOI":"10.1002\/ana.26431","type":"journal-article","created":{"date-parts":[[2022,6,11]],"date-time":"2022-06-11T04:23:46Z","timestamp":1654921426000},"page":"562-573","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Management of Cerebral Venous Thrombosis Due to Adenoviral <scp>COVID<\/scp>\u201019 Vaccination"],"prefix":"10.1002","volume":"92","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9053-584X","authenticated-orcid":false,"given":"Adrian","family":"Scutelnic","sequence":"first","affiliation":[{"name":"Department of Neurology, Inselspital, Bern University Hospital University of Bern  Bern Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katarzyna","family":"Krzywicka","sequence":"additional","affiliation":[{"name":"Department of Neurology, Amsterdam University Medical Centers University of Amsterdam  Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0108-9161","authenticated-orcid":false,"given":"Joshua","family":"Mbroh","sequence":"additional","affiliation":[{"name":"Hertie Institute for Clinical Brain Research Eberhard\u2010Karls University  Tuebingen Germany"},{"name":"Department of Neurology &amp; Stroke Eberhard\u2010Karls University  Tuebingen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anita","family":"van de Munckhof","sequence":"additional","affiliation":[{"name":"Department of Neurology, Amsterdam University Medical Centers University of Amsterdam  Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5614-9689","authenticated-orcid":false,"given":"Mayte S\u00e1nchez","family":"van Kammen","sequence":"additional","affiliation":[{"name":"Department of Neurology, Amsterdam University Medical Centers University of Amsterdam  Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diana Aguiar","family":"de Sousa","sequence":"additional","affiliation":[{"name":"CEEM and Institute of Anatomy, Faculty of Medicine University of Lisbon  Lisbon Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7628-5044","authenticated-orcid":false,"given":"Erik","family":"Lindgren","sequence":"additional","affiliation":[{"name":"Department of Neurology Sahlgrenska University Hospital  Gothenburg Sweden"},{"name":"Department of Clinical Neuroscience Institute of Neuroscience and Physiology  Gothenburg Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katarina","family":"Jood","sequence":"additional","affiliation":[{"name":"Department of Neurology Sahlgrenska University Hospital  Gothenburg Sweden"},{"name":"Department of Clinical Neuroscience Institute of Neuroscience and Physiology  Gothenburg 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Neurology Royal Darwin Hospital  Tiwi Northern Territory Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8843-5890","authenticated-orcid":false,"given":"Carlos Garcia","family":"Esperon","sequence":"additional","affiliation":[{"name":"Department of Neurology John Hunter Hospital  Newcastle New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beng Lim Alvin","family":"Chew","sequence":"additional","affiliation":[{"name":"Department of Neurology John Hunter Hospital  Newcastle New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy J.","family":"Kleinig","sequence":"additional","affiliation":[{"name":"Department of Neurology Royal Adelaide Hospital  Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina","family":"Soriano","sequence":"additional","affiliation":[{"name":"Department of Neurology 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