Delayed headache after COVID-19 vaccination: a red flag for vaccine induced cerebral venous thrombosis.
J Headache Pain
; 22(1): 108, 2021 Sep 17.
Article
in English
| MEDLINE | ID: covidwho-1416805
ABSTRACT
BACKGROUND:
Headache is a frequent symptom following COVID-19 immunization with a typical onset within days post-vaccination. Cases of cerebral venous thrombosis (CVT) have been reported in adenovirus vector-based COVID-19 vaccine recipients.FINDINGS:
We reviewed all vaccine related CVT published cases by April 30, 2021. We assessed demographic, clinical variables and the interval between the vaccination and onset of headache. We assessed whether the presence of headache was associated with higher probability of death or intracranial hemorrhage. We identified 77 cases of CVT after COVID-19 vaccination. Patients' age was below 60 years in 74/77 (95.8%) cases and 61/68 (89.7%) were women. Headache was described in 38/77 (49.4%) cases, and in 35/38 (92.1%) was associated with other symptoms. Multiple organ thrombosis was reported in 19/77 (24.7%) cases, intracranial hemorrhage in 33/77 (42.9%) cases and 19/77 (24.7%) patients died. The median time between vaccination and CVT-related headache onset was 8 (interquartile range 7.0-9.7) days. The presence of headache was associated with a higher odd of intracranial hemorrhage (OR 7.4; 95% CI 2.7-20.8, p < 0.001), but not with death (OR 0.51, 95% CI 0.18-1.47, p = 0.213).CONCLUSION:
Delayed onset of headache following an adenovirus vector-based COVID-19 vaccine is associated with development of CVT. Patients with new-onset headache, 1 week after vaccination with an adenovirus vector-based vaccine, should receive a thorough clinical evaluation and CVT must be ruled out.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Vaccines
/
Venous Thrombosis
/
COVID-19
Type of study:
Experimental Studies
/
Prognostic study
Topics:
Vaccines
Limits:
Female
/
Humans
/
Middle aged
Language:
English
Journal:
J Headache Pain
Journal subject:
Internal Medicine
/
Neurology
/
Psychophysiology
Year:
2021
Document Type:
Article
Affiliation country:
S10194-021-01324-5
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