ABSTRACT
Introduction: Recent reports have shown several cases of cerebrovascular events after vaccination against COVID-19. The effects have been described mainly in women within the first two weeks of receiving the vaccine. Clinical Case: We describe here the first Colombian case of a cerebrovascular event after vaccination against COVID-19 in a 67-year-old woman with a vascular history. Four days after application of the messenger ribonucleic acid (mRNA) vaccine, she exhibited deviation of the labial commissure, ipsilateral ptosis, and limitation of march with lateralization. The event was associated with a subacute ischemic event in the right thalamus in parasagittal situation, changes in chronic ischemic microangiopathy of small vessels, and vascular crossing in the right cerebellar angle, without other alternative causes. Conclusion: The development and rapid use of vaccines has allowed the hospitalization and mortality statistics associated with COVID-19 to be reduced, but at the same time, it has generated concern about the potential side effects, generating controversy among the general population, especially in individuals with cardiovascular diseases. In our case, we provided evidence for the discussion of potential cerebrovascular events related to the application of vaccines in older people with a history of cerebrovascular diseases. This was done in order to analyze and control in subsequent studies the modulation of medical history on the likely effects of vaccination. However, despite the unavoidable side effects, the benefits of vaccination are superior.
ABSTRACT
RESUMEN Los pacientes trasplantados son susceptibles a complicaciones neurológicas derivadas entre otros aspectos, de las complicaciones mismas del procedimiento, el cuidado crítico que requieren los pacientes, y de los efectos secundarios a los medicamentos utilizados y el efecto inmunoderpresor de los mismos. Este último hace que los pacientes estén expuestos a infecciones oportunistas. Dentro de estas, las Infecciones del Sistema Nervioso Central en el paciente trasplantado constituyen un reto diagnóstico. Dentro de los procesos infecciosos es importante tener en cuenta aquellos relacionados con hongos, especialmente en los 3 primeros meses posterior al trasplante. Se presenta el caso de un paciente 67 años con antecedente de trasplante cardíaco, quien ingresa con un proceso febril y posterior compromiso neurológico.
SUMMARY Transplanted patients are susceptible to neurological complications arising, among other things, from the complications of the procedure itself, the critical care, and the side effects to the medications used and the immunodepressive effect thereof. It's causes patients to be exposed to opportunistic infections. Within these, Central Nervous System Infections in the transplanted patient constitute a diagnostic challenge. Within infectious processes it is important to take into account those related to fungi, especially in the first 3 months after transplantation. We present the case of a 67 years old patient with a history of heart transplantation, which enters with a febrile process and subsequent neurological compromise.