Large hemorrhagic stroke after ChAdOx1 nCoV-19 vaccination: A case report

Acta Neurol Scand. 2021 Dec;144(6):717-718. doi: 10.1111/ane.13505. Epub 2021 Jul 17.

Abstract

Background: The anti-COVID-19 vaccines are new, and we should be alert of potential adverse effects of them.

Aims of the study: To report a case of a large hemorrhagic stroke 5 days after ChAdOx1 nCoV-19 vaccination.

Methods: Clinical, imaging, and laboratory data of a patient with stroke admitted to our emergency department.

Results: A woman, 57 years old, took the first dose of the ChAdOx1 nCoV-19 vaccine and shortly thereafter presented mild systemic symptoms and started on aspirin. On day 5, she had a sudden onset of sweating and paleness, which has followed by left hemiparesis, vomiting, and somnolence. Computed tomography showed a large right deep frontal lobe parenchymal hematoma with the inundation of the entire ventricular system. Platelets count, fibrinogen, prothrombin time, and D-dimer were normal. Digital subtraction angiography did not show any signs of thrombosis or aneurysms in brain circulation.

Conclusions: Clinicians should be aware of cerebrovascular adverse effects of ChAdOx1 nCoV-19, including out-of-context of vaccine-induced immune thrombotic thrombocytopenia.

Keywords: COVID-19; case report; stroke.

Publication types

  • Case Reports

MeSH terms

  • COVID-19 Vaccines
  • COVID-19*
  • ChAdOx1 nCoV-19 / adverse effects*
  • Female
  • Hemorrhagic Stroke*
  • Humans
  • Middle Aged
  • Thrombocytopenia*
  • Vaccination

Substances

  • COVID-19 Vaccines
  • ChAdOx1 nCoV-19