Intracerebral bleeding with ventricular rupture shortly after 1st dose of the #Covidvaccine (Pfizer-BioNTech).

 Intracerebral bleeding with ventricular rupture shortly after 1st dose of the #Covidvaccine (Pfizer-BioNTech).

Case of a 67-year-old woman. https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC8553377/

Lobar bleeding with ventricular rupture shortly after first dosage of an mRNA-based SARS-CoV-2 vaccine

Josef Finsterer

Abstract

Vaccination against SARS-CoV-2 is beneficial but may be rarely accompanied by side effects.

We report a 67yo female who developed visual impairment, dysarthria, confusion, and fatigue a few hours after a first dosage with an mRNA-based SARS-CoV-2 vaccine (Pfizer). Her previous history listed diabetes, arterial hypertension, arterial occlusive disease, a single renal cyst on the left side, smoking, and ischemic stroke 20y earlier. Stroke was complicated by normal pressure hydrocephalus requiring placement of a ventriculo-atrial (VA)-shunt. Cerebral imaging revealed a right-sided intracerebral bleeding with ventricular rupture and correct placement of the VA-shunt. Neurosurgeons decided against surgical treatment. The further course was dominated by prolonged confusion, visual impairment, and disorientation but ultimately only minor deficits.

In conclusion, a single patient experienced intracerebral bleeding with ventricular rupture shortly after application of the first jab of an mRNA-based SARS-CoV-2 vaccine. Whether bleeding was causally related to the vaccination or occurred coincidentally, remains speculative.

Case report

The patient is a 67yo female, height 163 cm, weight, 77 kg, who presented with visual impairment, dysarthria, confusion, and fatigue. Her previous history was positive for vaccination with an mRNA-based SARS-CoV-2 vaccine (Pfizer) a few hours earlier, diabetes, arterial hypertension, smoking (20cig/d), arterial occlusive disease, a single renal cyst on the left side, endoscopic cholecystectomy, cervical conisation, and ischemic stroke 20y earlier. The previous stroke had been complicated by normal pressure hydrocephalus communicans requiring implantation of a ventriculo-atrial (VA)-shunt. Her medication on admission included escitalopram, metformin, folic acid, tramadol, lisinopril, rosuvastatin, doxacosin, and rilmenidin. Clinical neurologic exam on admission revealed bradyphrenia, neglect to the left, gaze palsy to the right, and hemianopia to the left, corresponding with an NIHSS score of 3. Blood pressure was normal. Multimodal cerebral MRI revealed a right parietal, lobar bleeding with ventricular rupture and a VA-shunt from the right side with the shunt tip in the anterior horn of the left lateral ventricle (Fig. 1 ). Neurosurgeons did not recommend surgical removal of the bleeding. Functionality of the VA-shunt was confirmed. Blood tests were non-informative except for mildly elevated D-dimer of 0.89 mg/L (n: <0.5 mg/L). Follow-up cerebral CT scan did not show progressive widening of the ventricular system why the shunt adjustment was not changed. CT-angiography of the cerebral vessels did not reveal a source of the bleeding. During the following days the patient presented with confusion and visual impairment but was able to walk, speak, and swallow without restriction.

CONTINUE HERE https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC8553377/