Spectrum of Neuroimaging Findings in Post-COVID-19 Vaccination: A Case Series and Review of Literature

Abstract

Background and Purpose: The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first detected in Wuhan, China in December 2019. Symptoms range from mild flu-like symptoms to more severe presentations, including pneumonia, acute respiratory distress syndrome (ARDS), and even death. In response to the COVID-19 pandemic, the Emergency Use Authorization (EUA) approved the use of several vaccines. Because vaccines have been fast-tracked for emergency use, the short and long-term safety profile has been an area of concern. The aim of this paper is to extensively review published literature regarding post-COVID-19 vaccination neurological complications and characterize neuroimaging findings from three case presentations for early diagnosis and treatment. Methods: The analysis includes data from PubMed and Google Scholar. Articles included were retrieved from database inception beginning December 2020 with no language restrictions. Terms used include “SARS-CoV-2”, “post Covid vaccination”, “neurological complications”, “Guillain-barre Syndrome”, “Transverse-myelitis”, “Cerebral Venous Sinus thrombosis”, and “Cerebral hemorrhage”. Results: The literature review yielded several neurological complications post vaccination, including cerebral sinus venous thrombosis, transverse myelitis, Guillain-Barré Syndrome and optic neuritis, to name a few. Patient case presentation findings were consistent with documented results in published literature. Conclusions: We present a case series with a thorough literature review documenting adverse neurological affects following COVID-19 vaccination. Our case presentations and literature review highlight the importance of neuroimaging when diagnosing post-COVID-19 vaccination adverse effects. MRI imaging study is an important tool to be considered in patients presenting with post-COVID-19 vaccination-related unexplained neurological symptoms for accurate diagnosis.

Vitamin B12 and D deficiency as cofactors of COVID-19 vaccine-induced chronic neurological adverse reactions: Two cases and a hypothesis

“…Similarly, another case series found 21 cases of new-onset, or flares of, inflammatory/autoimmune neurological conditions following COVID-19 vaccination, including eight cases of central nervous system demyelination, four cases of inflammatory peripheral neuropathies, and three cases of myositis (Kaulen et al, 2021). Finally, neuroinflammation and demyelination following COVID-19 vaccination have been imaged using MRI (Camera et al, 2021;Kania et al, 2021;Rinaldi et al, 2021;Sriwastava et al, 2021).…”

Clinical characteristics, radiological features and prognostic factors of transverse myelitis following COVID-19 vaccination: A systematic review

“…The PRISMA flowchart ( Figure 1 ) showed a search strategy for our review. The present study consisted of 28 studies, including 26 case reports, one case series, and one cross-sectional, and the pooled data of 31 patients with COVID-19 vaccine-associated ATM is extracted ( Sriwastava et al, 2021 , Sepahvand et al, 2022 , Tan et al, 2021 , Corrêa et al, 2021 , Vegezzi et al, 2021 , Hsiao et al, 2021 , Pagenkopf and Südmeyer, 2021 , Notghi et al, 2021 , Gao et al, 2021 , Malhotra et al, 2021 , Khan et al, 2022 , Erdem et al, 2021 , Hirose et al, 2021 , Tahir et al, 2021 , Miyaue et al, 2021 , Fujikawa et al, 2021 , Kaulen et al, 2022 , McLean and Trefts, 2021 , Alabkal et al, 2021 , Fitzsimmons and Nance, 2021 , Nakano et al, 2022 , Spataro et al, 2022 , Cabral et al, 2022 , Khan et al, 2022 , Maroufi et al, 2022 , Eom et al, 2022 , Netravathi et al, 2022 , Esechie et al, 2022 ). All of the selected studies were written in the English language.…”

Chronic Inflammatory Demyelinating Polyneuropathy Post-mRNA-1273 Vaccination

“…Due to the severity of the COVID-19 pandemic, massive efforts were made to shorten the timing of vaccine development. Neurological problems associated with SARS-CoV-2 vaccinations are rare [ 6 ]. In their comprehensive analysis, Chen et al described various neurological adverse effects associated with routinely available COVID-19 vaccinations [ 7 , 8 ].…”