Fatal Post COVID mRNA-Vaccine Associated Cerebral Ischemia

Abstract

Background Venous thromboses have been linked to several COVID-19 vaccines, but there is limited information on the Moderna vaccine’s effect on the risk of arterial thrombosis. Here we describe a case of post-Moderna COVID-19 vaccination arterial infarct with vaccine-associated diffuse cortical edema that was complicated by refractory intracranial hypertension. Case Summary 24 hrs after receiving her first dose of the Moderna COVID-19 vaccine, a 30-year-old female developed severe headache. Three weeks later she was admitted with subacute headache and confusion. Imaging initially showed scattered cortical thrombosis with an elevated opening pressure on lumbar puncture. An external ventricular drain was placed, but she continued to have elevated intracranial pressure. Ultimately, she required a hemicraniectomy, but intractable cerebral edema resulted in her death. Pathology was consistent with thrombosis and associated inflammatory response. Conclusion Though correlational, her medical team surmised that the mRNA vaccine may have contributed to this presentation. The side effects of COVID-19 infection and vaccination are still incompletely understood. Though complications are rare, clinicians should be aware of presentations like this one.

Post COVID mRNA-Vaccine Associated Cerebral Ischemia: Comment

“…Dear Editor, we would like to share ideas on the publication "Delayed exacerbation of COVID-19 pneumonia in vaccinated kidney transplant recipients receiving immunosuppressants: a case series. 1 " McMillan et al describe a case of post-Moderna COVID-19 immunization arterial infarction exacerbated by intractable cerebral hypertension. 1 McMillan et al stated that, while correlational, her medical team suspected that the mRNA vaccine played a role in this presentation.…”

“…1 " McMillan et al describe a case of post-Moderna COVID-19 immunization arterial infarction exacerbated by intractable cerebral hypertension. 1 McMillan et al stated that, while correlational, her medical team suspected that the mRNA vaccine played a role in this presentation. The negative effects of COVID-19 infection and immunization are largely unknown.…”

“…The negative effects of COVID-19 infection and immunization are largely unknown. 1 McMillan et al stated that, while problems are uncommon, doctors should be aware of cases like these. 1 We note the possibility of thrombohemostatic problems following the COVID-19 vaccination.…”

“…1 McMillan et al stated that, while problems are uncommon, doctors should be aware of cases like these. 1 We note the possibility of thrombohemostatic problems following the COVID-19 vaccination. COVID-19 vaccination, like natural infection, can elicit an immune response.…”

“…1 McMillan et al stated that, while problems are uncommon, doctors should be aware of cases like these. 1…”