{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T18:38:54Z","timestamp":1778870334576,"version":"3.51.4"},"reference-count":5,"publisher":"BMJ","issue":"6","license":[{"start":{"date-parts":[[2021,6,1]],"date-time":"2021-06-01T00:00:00Z","timestamp":1622505600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/bmj.com\/coronavirus\/usage"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,5,29]]},"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:p>A 27-year-old fit and well man presented with intermittent headaches associated with eye floaters and vomiting. His symptoms started 48 hours after having the first dose of ChADOx1 nCOV-19 vaccine (Vaxzevria, previously AstraZeneca COVID-19 vaccine; AstraZeneca) and bloods showed raised D-dimer, low platelets and fibrinogen. CT venogram demonstrated significant cerebral venous sinus thrombosis. He was immediately started on intravenous immunoglobulins and dabigatran after liasing with haematologist. The next day, he complained of worsening headache and new homonymous hemianopia. Repeat CT of the head showed an acute parenchymal bleed with subdural extension and was given idarucizumab and high-dose steroids. He had an emergency decompressive craniotomy and external ventricular drain as his intracranial pressures were difficult to control. Despite full medical and surgical management, his intracranial pressures continued to rise and his brain injury was felt to be too devastating and was deemed unsurvivable.<\/jats:p>","DOI":"10.1136\/bcr-2021-243931","type":"journal-article","created":{"date-parts":[[2021,6,16]],"date-time":"2021-06-16T13:00:36Z","timestamp":1623848436000},"page":"e243931","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":38,"title":["ChAdOx1 nCOV-19 vaccine-induced immune thrombotic thrombocytopenia and cerebral venous sinus thrombosis (CVST)"],"prefix":"10.1136","volume":"14","author":[{"given":"Preethi","family":"Suresh","sequence":"first","affiliation":[{"name":"Cardiology, West Suffolk Hospitals NHS Trust, Bury Saint Edmunds, Suffolk, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William","family":"Petchey","sequence":"additional","affiliation":[{"name":"Cardiology, West Suffolk Hospitals NHS Trust, Bury Saint Edmunds, Suffolk, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,6,16]]},"reference":[{"key":"2025082708533158000_14.6.e243931.1","doi-asserted-by":"crossref","DOI":"10.1056\/NEJMoa2104840","article-title":"Thrombotic thrombocytopenia after ChAdOx1 nCov-19 vaccination","author":"Greinacher","year":"2021","journal-title":"N Engl J Med"},{"key":"2025082708533158000_14.6.e243931.2","doi-asserted-by":"crossref","DOI":"10.1056\/NEJMoa2104882","article-title":"Thrombosis and thrombocytopenia after ChAdOx1 nCoV-19 vaccination","author":"Schultz","year":"2021","journal-title":"N Engl J Med"},{"key":"2025082708533158000_14.6.e243931.3","unstructured":"Guidance produced from the expert haematology panel focused on covid-19 vaccine induced thrombosis and thrombocytopenia. Available: https:\/\/b-s-h.org.uk\/media\/19530\/guidance-version-13-on-mngmt-of-thrombosis-with-thrombocytopenia-occurring-after-c-19-vaccine_20210407.pdf [Accessed 7 Apr 2021]."},{"key":"2025082708533158000_14.6.e243931.4","unstructured":"Medicines & Healthcare products Regulatory Agency . MHRA (2006) healthcare professional reporting of suspected adverse drug reactions. Available: http:\/\/www.mhra.gov.uk"},{"key":"2025082708533158000_14.6.e243931.5","doi-asserted-by":"crossref","unstructured":"Mahase E . AstraZeneca vaccine: Blood clots are \u201cextremely rare\u201d and benefits outweigh risks, regulators conclude. BMJ 2021;373.doi:10.1136\/bmj.n931","DOI":"10.1136\/bmj.n931"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2021-243931","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T15:53:37Z","timestamp":1756310017000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2021-243931"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6]]},"references-count":5,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2021,6,16]]},"published-print":{"date-parts":[[2021,6]]}},"alternative-id":["10.1136\/bcr-2021-243931"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2021-243931","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6]]}}}