We present three cases fulfilling diagnostic criteria of hemorrhagic variants of acute disseminated encephalomyelitis (acute hemorrhagic encephalomyelitis, AHEM) occurring within 9 days after the first shot of ChAdOx1 nCoV-19. AHEM was diagnosed using magnetic resonance imaging, cerebrospinal fluid analysis and brain biopsy in one case. The close temporal association with the vaccination, the immune-related nature of the disease as well as the lack of other canonical precipitating factors suggested that AHEM was a vaccine-related adverse effect. We believe that AHEM might reflect a novel COVID-19 vaccine-related adverse event for which physicians should be vigilant and sensitized.
Keywords: COVID-19; ChAdOx1 nCoV-19; Weston-Hurst syndrome; acute disseminated encephalomyelitis; acute hemorrhagic encephalomyelitis; acute hemorrhagic leukoencephalitis; vaccination.
Copyright © 2022 Ancau, Liesche-Starnecker, Niederschweiberer, Krieg, Zimmer, Lingg, Kumpfmüller, Ikenberg, Ploner, Hemmer, Wunderlich, Mühlau and Knier.