{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T10:28:40Z","timestamp":1760956120036,"version":"3.44.0"},"reference-count":5,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2021,7,8]],"date-time":"2021-07-08T00:00:00Z","timestamp":1625702400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Stroke Vasc Neurol"],"accepted":{"date-parts":[[2021,6,9]]},"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:p>Vaccine-induced immune thrombotic thrombocytopenia (VITT) and cerebral venous sinus thrombosis (CVST) have been recently described as rare complications following vaccination against SARS-CoV-2 with vector vaccines. We report a case of a young woman who presented with VITT and cerebral CVST 7\u2009days following vaccination with ChAdOx1 nCov-19 (AstraZeneca). While the initial MRI was considered void of pathological findings, MRI 3\u2009days later revealed extensive CVST of the transversal and sigmoidal sinus with intracerebral haemorrhage. Diagnostic tests including a platelet-factor-4-induced platelet activation assay confirmed the diagnosis of VITT. Treatment with intravenous immunoglobulins and argatroban resulted in a normalisation of platelet counts and remission of CVST.<\/jats:p>","DOI":"10.1136\/svn-2021-001095","type":"journal-article","created":{"date-parts":[[2021,7,8]],"date-time":"2021-07-08T11:56:23Z","timestamp":1625745383000},"page":"668-670","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":21,"title":["Cerebral venous sinus thrombosis after ChAdOx1 nCov-19 vaccination with a misleading first cerebral MRI scan"],"prefix":"10.1136","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0798-7149","authenticated-orcid":false,"given":"Benno","family":"Ikenberg","sequence":"first","affiliation":[{"name":"Department of Neurology, Klinikum rechts der Isar der Technischen Universit\u00e4t M\u00fcnchen, Munchen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9557-9243","authenticated-orcid":false,"given":"Antonia Franziska","family":"Demleitner","sequence":"additional","affiliation":[{"name":"Department of Neurology, Klinikum rechts der Isar der Technischen Universit\u00e4t M\u00fcnchen, Munchen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Thiele","sequence":"additional","affiliation":[{"name":"Institut f\u00fcr Immunologie und Transfusionsmedizin, Universit\u00e4tsmedizin Greifswald, Greifswald, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benedikt","family":"Wiestler","sequence":"additional","affiliation":[{"name":"Department of Diagnostic und Interventional Neuroradiology, Klinikum rechts der Isar der Technischen Universit\u00e4t M\u00fcnchen, Munchen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katharina","family":"G\u00f6tze","sequence":"additional","affiliation":[{"name":"Department of Medicine III, Klinikum rechts der Isar der Technischen Universit\u00e4t M\u00fcnchen, Munchen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georg","family":"M\u00f6\u00dfmer","sequence":"additional","affiliation":[{"name":"Institute for Clinical Chemistry and Pathobiochemistry, Klinikum rechts der Isar der Technischen Universit\u00e4t M\u00fcnchen, Munchen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9362-7096","authenticated-orcid":false,"given":"Paul","family":"Lingor","sequence":"additional","affiliation":[{"name":"Department of Neurology, Klinikum rechts der Isar der Technischen Universit\u00e4t M\u00fcnchen, Munchen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,7,8]]},"reference":[{"key":"2025081709284210000_6.4.668.1","doi-asserted-by":"crossref","first-page":"2124","DOI":"10.1056\/NEJMoa2104882","article-title":"Thrombosis and thrombocytopenia after ChAdOx1 nCoV-19 vaccination","volume":"384","author":"Schultz","year":"2021","journal-title":"N Engl J Med"},{"key":"2025081709284210000_6.4.668.2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2104840"},{"key":"2025081709284210000_6.4.668.3","doi-asserted-by":"crossref","unstructured":"Oldenburg J , Klamroth R , Langer F . Diagnosis and management of vaccine-related thrombosis following AstraZeneca COVID-19 vaccination: guidance statement from the GTH. Hamostaseologie 2021.doi:10.1055\/a-1469-7481","DOI":"10.1055\/a-1469-7481"},{"key":"2025081709284210000_6.4.668.4","doi-asserted-by":"crossref","first-page":"1067","DOI":"10.1055\/s-0038-1642636","article-title":"The performance of CT versus MRI in the differential diagnosis of cerebral venous thrombosis","volume":"118","author":"Xu","year":"2018","journal-title":"Thromb Haemost"},{"key":"2025081709284210000_6.4.668.5","unstructured":"AstraZeneca\u2019s COVID-19 vaccine: EMA finds possible link to very rare cases of unusual blood clots with low blood platelets. Available: https:\/\/www.ema.europa.eu\/en\/news\/astrazenecas-covid-19-vaccine-ema-finds-possible-link-very-rare-cases-unusual-blood-clots-low-blood [Accessed 16 Apr 2021]."}],"container-title":["Stroke and Vascular Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/svn-2021-001095","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,17]],"date-time":"2025-08-17T16:28:51Z","timestamp":1755448131000},"score":1,"resource":{"primary":{"URL":"https:\/\/svn.bmj.com\/lookup\/doi\/10.1136\/svn-2021-001095"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,8]]},"references-count":5,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2021,12,24]]},"published-print":{"date-parts":[[2021,12]]}},"alternative-id":["10.1136\/svn-2021-001095"],"URL":"https:\/\/doi.org\/10.1136\/svn-2021-001095","relation":{},"ISSN":["2059-8688","2059-8696"],"issn-type":[{"type":"print","value":"2059-8688"},{"type":"electronic","value":"2059-8696"}],"subject":[],"published":{"date-parts":[[2021,7,8]]}}}