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Decompressive surge...
Decompressive surgery in cerebral venous sinus thrombosis due to vaccine-induced immune thrombotic thrombocytopenia.
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Krzywicka, Katarzyna (author)
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Aguiar de Sousa, Diana (author)
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Cordonnier, Charlotte (author)
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Bode, Felix J (author)
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Field, Thalia S (author)
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Michalski, Dominik (author)
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Pelz, Johann (author)
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Skjelland, Mona (author)
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Wiedmann, Markus (author)
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Zimmermann, Julian (author)
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Wittstock, Matthias (author)
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Zanotti, Bruno (author)
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Ciccone, Alfonso (author)
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Bandettini di Poggio, Monica (author)
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Borhani-Haghighi, Afshin (author)
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Chatterton, Sophie (author)
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Aujayeb, Avinash (author)
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Devroye, Annemie (author)
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Dizonno, Vanessa (author)
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Geeraerts, Thomas (author)
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Giammello, Fabrizio (author)
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Günther, Albrecht (author)
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Ichaporia, Nasli R (author)
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Kleinig, Timothy (author)
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Kristoffersen, Espen S (author)
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Lemmens, Robin (author)
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De Maistre, Emmanuel (author)
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Mirzaasgari, Zahra (author)
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Payen, Jean-Francois (author)
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Putaala, Jukka (author)
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Petruzzellis, Marco (author)
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Raposo, Nicolas (author)
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Sadeghi-Hokmabadi, Elyar (author)
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Schoenenberger, Silvia (author)
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Umaiorubahan, Meenakshisundaram (author)
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Sylaja, Padmavathy N (author)
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van de Munckhof, Anita (author)
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Sánchez van Kammen, Mayte (author)
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- Lindgren, Erik, 1993 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap,Institute of Neuroscience and Physiology, Department of Clinical Neuroscience
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- Jood, Katarina, 1966 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap,Institute of Neuroscience and Physiology, Department of Clinical Neuroscience
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Scutelnic, Adrian (author)
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Heldner, Mirjam R (author)
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Poli, Sven (author)
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Kruip, Marieke J H A (author)
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Arauz, Antonio (author)
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Conforto, Adriana B (author)
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Aaron, Sanjith (author)
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Middeldorp, Saskia (author)
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Tatlisumak, Turgut (author)
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Arnold, Marcel (author)
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Coutinho, Jonathan M (author)
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Ferro, José M (author)
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(creator_code:org_t)
- 2023-03-05
- 2023
- English.
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In: European journal of neurology. - : Wiley. - 1468-1331 .- 1351-5101. ; 30:5, s. 1335-1345
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https://gup.ub.gu.se...
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https://doi.org/10.1...
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Abstract
Subject headings
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- Cerebral venous sinus thrombosis due to vaccine-induced immune thrombotic thrombocytopenia (CVST-VITT) is an adverse drug reaction occurring after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination. CVST-VITT patients often present with large intracerebral haemorrhages and a high proportion undergoes decompressive surgery. Clinical characteristics, therapeutic management and outcomes of CVST-VITT patients who underwent decompressive surgery are described and predictors of in-hospital mortality in these patients are explored.Data from an ongoing international registry of patients who developed CVST within 28days of SARS-CoV-2 vaccination, reported between 29 March 2021 and 10 May 2022, were used. Definite, probable and possible VITT cases, as defined by Pavord et al. (N Engl J Med 2021; 385: 1680-1689), were included.Decompressive surgery was performed in 34/128 (27%) patients with CVST-VITT. In-hospital mortality was 22/34 (65%) in the surgical and 27/94 (29%) in the non-surgical group (p<0.001). In all surgical cases, the cause of death was brain herniation. The highest mortality rates were found amongst patients with preoperative coma (17/18, 94% vs. 4/14, 29% in the non-comatose; p<0.001) and bilaterally absent pupillary reflexes (7/7, 100% vs. 6/9, 67% with unilaterally reactive pupil, and 4/11, 36% with bilaterally reactive pupils; p=0.023). Postoperative imaging revealed worsening of index haemorrhagic lesion in 19 (70%) patients and new haemorrhagic lesions in 16 (59%) patients. At a median follow-up of 6months, 8/10 of surgical CVST-VITT who survived admission were functionally independent.Almost two-thirds of surgical CVST-VITT patients died during hospital admission. Preoperative coma and bilateral absence of pupillary responses were associated with higher mortality rates. Survivors often achieved functional independence.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Neurologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Neurology (hsv//eng)
Keyword
- Humans
- Coma
- COVID-19
- prevention & control
- COVID-19 Vaccines
- adverse effects
- Sinus Thrombosis
- Intracranial
- chemically induced
- surgery
- Thrombocytopenia
- chemically induced
- surgery
- Purpura
- Thrombocytopenic
- Idiopathic
- chemically induced
- surgery
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Krzywicka, Katar ...
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Aguiar de Sousa, ...
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Cordonnier, Char ...
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Bode, Felix J
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Field, Thalia S
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Michalski, Domin ...
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show more...
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Pelz, Johann
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Skjelland, Mona
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Wiedmann, Markus
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Zimmermann, Juli ...
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Wittstock, Matth ...
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Zanotti, Bruno
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Ciccone, Alfonso
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Bandettini di Po ...
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Borhani-Haghighi ...
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Chatterton, Soph ...
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Aujayeb, Avinash
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Devroye, Annemie
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Dizonno, Vanessa
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Geeraerts, Thoma ...
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Giammello, Fabri ...
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Günther, Albrech ...
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Ichaporia, Nasli ...
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Kleinig, Timothy
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Kristoffersen, E ...
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Lemmens, Robin
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De Maistre, Emma ...
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Mirzaasgari, Zah ...
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Payen, Jean-Fran ...
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Putaala, Jukka
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Petruzzellis, Ma ...
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Raposo, Nicolas
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Sadeghi-Hokmabad ...
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Schoenenberger, ...
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Umaiorubahan, Me ...
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Sylaja, Padmavat ...
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van de Munckhof, ...
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Sánchez van Kamm ...
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Lindgren, Erik, ...
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Jood, Katarina, ...
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Scutelnic, Adria ...
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Heldner, Mirjam ...
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Poli, Sven
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Kruip, Marieke J ...
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Arauz, Antonio
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Conforto, Adrian ...
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Aaron, Sanjith
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Middeldorp, Sask ...
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Tatlisumak, Turg ...
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Arnold, Marcel
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Coutinho, Jonath ...
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Ferro, José M
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Neurology
- Articles in the publication
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European journal ...
- By the university
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University of Gothenburg