DECOMPRESSIVE SURGERY IN CEREBRAL VENOUS SINUS THROMBOSIS WITH VACCINE-INDUCED IMMUNE THROMBOTIC THROMBOCYTOPENIA

Background and aims: Cerebral venous sinus thrombosis with thrombosis with thrombocytopenia syndrome (CVST-TTS) is a serious adverse drug reaction after adenoviral SARS-CoV-2 vaccinations. CVST-TTS patients may need decompressive surgery to avoid fatal brain herniation, but despite this intervention, many CVST-TTS patients die during the initial hospital admission. Here, we describe the characteristics and outcomes of CVST-TTS patients who underwent decompressive surgery and explore predictors of mortality in CVST-TTS patients. Methods: We used data from an ongoing international registry collecting data from patients who developed CVST within 28 days of SARS-CoV-2 vaccination, reported between 29 March and 9 December 2021. TTS was defined in accordance with the Brighton Collaboration case definition. Results: Out of 97 CVST-TTS patients, 29 (30%) underwent decompressive surgery. All operated patients had an intracerebral haemorrhage before the surgery. In-hospital mortality was 19/29 (66%) in the operated and 23/68 (34%) in the non-operated group. In the operated group, the highest mortality rate was among patients who were in coma before the surgery (14/15, 93% vs 4/12, 33% in those not in coma), had bilateral absence of the pupillary response (7/7, 100% vs 8/16, 50% in patients with uni/bilateral pupillary response) and platelet count <50 x103/μL (11/14, 79% vs 6/12, 50% in cases with a platelet count ≥50 x103/μL). Conclusion: Mortality rate of CVST-TTS patients who underwent decompressive surgery is extremely high. Among the operated patients, coma before the surgery, bilateral absence of the pupillary response, and platelet count <50 x103/μL were the predictors of mortality.

The Mental Well-Being of Young Children and Families at the Beginning of the COVID-19 Pandemic in Germany

During the spring of 2020, the lockdown in Europe, enacted as a countermeasure to the COVID-19 pandemic, dramatically changed the social and daily life of young families. This online study explored the potential consequences of these unprecedented circumstances for the well-being of young German families. Caregivers completed a standardized questionnaire on their positive mental well-being and open-ended questions referring to their family situation and children. Although there is an emerging body of research describing pandemic-related outcomes in older children, little is known about its impact during early development. Hence, our analyses focused on a subset of caregivers of N = 798 children aged 0 to 23 months. Answers to open-ended questions revealed predominantly negative changes in their children and family life as a whole. During the lockdown, the well-being of the caregivers decreased. Taken together, the data show that social changes caused by the tockdown affected the well-being of young families. Potential mechanisms of stress transmission between parents and children are discussed.