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Cerebral Venous Thrombosis after BNT162b2 mRNA SARS-CoV-2 vaccine

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ELSEVIER
DOI: 10.1016/j.jstrokecerebrovasdis.2021.105906

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Cerebral Venous Thrombosis; COVID-19; SARS-CoV-2; Thromboembolism

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Concerns have been raised about venous thromboembolism, specifically cerebral venous thrombosis, following the development of SARS-CoV-2 vaccines. While cases of cerebral venous thrombosis have been reported after viral vector vaccine administration, two cases of cerebral venous thrombosis following mRNA vaccine administration did not exhibit thrombocytopenia or anti platelet antibodies. This suggests that the pathophysiology of these cases may not differ significantly from cerebral venous thrombosis not associated with SARS-CoV-2 vaccination.
The development of SARS-CoV-2 vaccines has raised several concerns regarding venous thromboembolism, namely cerebral venous thrombosis. Although cerebral venous thrombosis has been reported after administration of a viral vector vaccine, due to a possible auto-immune mechanism inducing thrombocytopenia, the same has not happened in mRNA vaccines. We report two cases of cerebral venous thrombosis, shortly after administration of mRNA vaccine. In both patients, there was no evidence of thrombocytopenia or anti platelet antibodies, and alternative causes for cerebral venous thrombosis were found. As such, despite the temporal relation of both cases to vaccine administration, these types of cerebral venous thrombosis do not seem to be pathophysiological different from cerebral venous thrombosis not associated to SARS-CoV-2 vaccination. Continuous pharmacovigilance is necessary to monitor possible new events and clarify this association.

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