Neurosurgical considerations regarding decompressive craniectomy for intracerebral hemorrhage after SARS-CoV-2-vaccination in vaccine induced thrombotic thrombocytopenia-VITT

  • Given the ongoing global SARS-CoV-2-vaccination efforts, clinical awareness needs to be raised regarding the possibility of an increased incidence of SARS-CoV-2-vaccine-related immune-mediated thrombocytopenia in patients with intracerebral hemorrhage (ICH) secondary to cerebral sinus and vein thrombosis (CVT) requiring (emergency) neurosurgical treatment in the context of vaccine-induced immune thrombotic thrombocytopenia (VITT). Only recently, an association of vaccinations and cerebral sinus and vein thrombosis has been described. In a number of cases, neurosurgical treatment is warranted for these patients and special considerations are warranted when addressing the perioperative coagulation. We, herein, describe the past management of patients with VITT and established a literature-guided algorithm for the treatment of patients when addressing the impaired coagulation in these patients. Increasing insights addressing the pathophysiology of SARS-CoV-2-vaccine-related immune-mediated thrombocytopenia guide physicians in developing an interdisciplinary algorithm taking into account the special considerations of this disease.

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Author:Florian GeßlerORCiDGND, Ann Kristin Schmitz, Daniel DubinskiORCiDGND, Joshua D. BernstockORCiD, Felix LehmannORCiD, Sae-Yeon WonORCiDGND, Matthias Wittstock, Erdem Özer GüresirORCiDGND, Alexis HadjiathanasiouORCiD, Julian ZimmermannORCiDGND, Wolfgang MiesbachORCiDGND, Thomas Michael FreimanORCiDGND, Hartmut VatterORCiDGND, Patrick SchußORCiDGND
Parent Title (English):Journal of Clinical Medicine
Place of publication:Basel
Document Type:Article
Date of Publication (online):2021/06/24
Date of first Publication:2021/06/24
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2022/01/11
Tag:Covid-19; SARS-CoV-2; cerebral sinus and vein thrombosis (CVT); decompressive craniectomy; intracerebral hemorrhage (ICH); vaccination; vaccine-induced immune thrombotic thrombocytopenia (VITT)
Issue:13, art. 2777
Page Number:8
First Page:1
Last Page:8
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCreative Commons - Namensnennung 4.0