Cranioplasty after Decompressive Craniectomy (DC) in a Patient with Intracerebral Hemorrhage after SARS-CoV-2 Vaccination-Related Vaccine-Induced Thrombotic Thrombocytopenia (VITT)—Proposal of a Management Protocol for This Rare Pathological Condition
Abstract
:1. Introduction
2. Literature Review
2.1. Epidemiology and Diagnosis
2.2. Initial Pharmacological Treatment of VITT-Associated CVST
2.3. Duration of Anticoagulation
2.4. Reasons and Timing of Cranioplasty
3. Proposal of a Treatment Algorithm for Cranioplasty in Patients with VITT-Associated CVST with Special Considerations, e.g., Frequent Seizures/Falls
4. Exemplary Case Presentation
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
aPTT | activated partial thromboplastin time |
COVID-19 | coronavirus disease |
cSDH | chronic subdural hematoma |
CT | computed tomography |
CVST | cerebral venous sinus thrombosis |
DC | decompressive hemicraniectomy |
ELISA | enzyme-linked immunosorbent assay |
HIT | heparin-induced thrombocytopenia |
ICH | intracerebral hemorrhage |
ICP | intracranial pressure |
IVIg | intravenous immunoglobulin |
MR | magnetic resonance |
MRI | magnetic resonance imaging |
PF4 | platelet factor 4 |
PIPA | PF4-induced platelet activation assay |
SAH | subarachnoid hemorrhage |
SARS-CoV-2 | severe acute respiratory syndrome coronavirus 2 |
VITT | vaccine-induced immune thrombotic thrombocytopenia and thrombosis |
References
- Mathieu, E.; Ritchie, H.; Rodés-Guirao, L.; Appel, C.; Giattino, C.; Hasell, J.; Macdonald, B.; Dattani, S.; Beltekian, D.; Ortiz-Ospina, E. Max Roser Coronavirus Pandemic (COVID-19). Available online: https://ourworldindata.org/covid-vaccinations?country=DEU (accessed on 4 January 2023).
- Watson, O.J.; Barnsley, G.; Toor, J.; Hogan, A.B.; Winskill, P.; Ghani, A.C. Global impact of the first year of COVID-19 vaccination: A mathematical modelling study. Lancet Infect. Dis. 2022, 22, 1293–1302. [Google Scholar] [CrossRef] [PubMed]
- Klok, F.A.; Pai, M.; Huisman, M.V.; Makris, M. Vaccine-induced immune thrombotic thrombocytopenia. Lancet Haematol. 2022, 9, e73–e80. [Google Scholar] [CrossRef] [PubMed]
- Greinacher, A.; Selleng, K.; Palankar, R.; Wesche, J.; Handtke, S.; Wolff, M.; Aurich, K.; Lalk, M.; Methling, K.; Völker, U.; et al. Insights in ChAdOx1 nCoV-19 vaccine-induced immune thrombotic thrombocyto-penia. Blood 2021, 138, 2256–2268. [Google Scholar] [CrossRef]
- Greinacher, A.; Thiele, T.; Warkentin, T.E.; Weisser, K.; Kyrle, P.A.; Eichinger, S. Thrombotic Thrombocytopenia after ChAdOx1 nCov-19 Vaccination. N. Engl. J. Med. 2021, 384, 2092–2101. [Google Scholar] [CrossRef] [PubMed]
- Scully, M.; Singh, D.; Lown, R.; Poles, A.; Solomon, T.; Levi, M.; Goldblatt, D.; Kotoucek, P.; Thomas, W.; Lester, W. Pathologic Antibodies to Platelet Factor 4 after ChAdOx1 nCoV-19 Vaccination. N. Engl. J. Med. 2021, 384, 2202–2211. [Google Scholar] [CrossRef] [PubMed]
- Barnwell, S.L.; Higashida, R.T.; van Halbach, V.; Dowd, C.F.; Hieshima, G.B. Direct Endovascular Thrombolytic Therapy for Dural Sinus Thrombosis. Neurosurgery 1991, 28, 135–142. [Google Scholar] [CrossRef]
- Einhäupl, K.M.; Villringer, A.; Meister, W.; Mehraein, S.; Garner, C.; Pellkofer, M.; Haberl, R.L.; Pfister, H.W.; Schmiedek, P. Heparin treatment in sinus venous thrombosis. Lancet 1991, 338, 597–600. [Google Scholar] [CrossRef] [PubMed]
- Nepal, G.; Kharel, S.; Bhagat, R.; Ka Shing, Y.; Ariel Coghlan, M.; Poudyal, P.; Ojha, R.; Sunder Shrestha, G. Safety and efficacy of Direct Oral Anticoagulants in cerebral venous thrombosis: A meta-analysis. Acta Neurol. Scand. 2022, 145, 10–23. [Google Scholar] [CrossRef] [PubMed]
- Perry, R.J.; Tamborska, A.; Singh, B.; Craven, B.; Marigold, R.; Arthur-Farraj, P.; Yeo, J.M.; Zhang, L.; Hassan-Smith, G.; Jones, M.; et al. Cerebral venous thrombosis after vaccination against COVID-19 in the UK: A multicentre cohort study. Lancet 2021, 398, 1147–1156. [Google Scholar] [CrossRef]
- Ferro, J.M.; Crassard, I.; Coutinho, J.M.; Canhão, P.; Barinagarrementeria, F.; Cucchiara, B.; Derex, L.; Lichy, C.; Masjuan, J.; Massaro, A.; et al. Decompressive surgery in cerebrovenous thrombosis: A multicenter registry and a systematic review of individual patient data. Stroke 2011, 42, 2825–2831. [Google Scholar] [CrossRef]
- Coutinho, J.M.; Majoie, C.B.L.M.; Coert, B.A.; Stam, J. Decompressive hemicraniectomy in cerebral sinus thrombosis: Consecutive case series and review of the literature. Stroke 2009, 40, 2233–2235. [Google Scholar] [CrossRef] [PubMed]
- Schultz, N.H.; Sørvoll, I.H.; Michelsen, A.E.; Munthe, L.A.; Lund-Johansen, F.; Ahlen, M.T.; Wiedmann, M.; Aamodt, A.-H.; Skattør, T.H.; Tjønnfjord, G.E.; et al. Thrombosis and Thrombocytopenia after ChAdOx1 nCoV-19 Vaccination. N. Engl. J. Med. 2021, 384, 2124–2130. [Google Scholar] [CrossRef] [PubMed]
- See, I.; Lale, A.; Marquez, P.; Streiff, M.B.; Wheeler, A.P.; Tepper, N.K.; Woo, E.J.; Broder, K.R.; Edwards, K.M.; Gallego, R.; et al. Case Series of Thrombosis with Thrombocytopenia Syndrome after COVID-19 Vaccination-United States, December 2020 to August 2021. Ann. Intern. Med. 2022, 175, 513–522. [Google Scholar] [CrossRef]
- Petito, E.; Gresele, P. Vaccine-Induced Immune Thrombotic Thrombocytopenia Two Years Later: Should It Still Be on the Scientific Agenda? Thromb. Haemost. 2023; Online ahead of print. [Google Scholar]
- Liu, Y.; Shao, Z.; Wang, H. SARS-CoV-2 vaccine-induced immune thrombotic thrombocytopenia. Thromb. Res. 2021, 209, 75–79. [Google Scholar] [CrossRef]
- Sharifian-Dorche, M.; Bahmanyar, M.; Sharifian-Dorche, A.; Mohammadi, P.; Nomovi, M.; Mowla, A. Vaccine-induced immune thrombotic thrombocytopenia and cerebral venous sinus thrombosis post COVID-19 vaccination; a systematic review. J. Neurol. Sci. 2021, 428, 117607. [Google Scholar] [CrossRef]
- Pavord, S.; Scully, M.; Hunt, B.J.; Lester, W.; Bagot, C.; Craven, B.; Rampotas, A.; Ambler, G.; Makris, M. Clinical Features of Vaccine-Induced Immune Thrombocytopenia and Thrombosis. N. Engl. J. Med. 2021, 385, 1680–1689. [Google Scholar] [CrossRef] [PubMed]
- Walter, U.; Volmer, E.; Wittstock, M.; Storch, A.; Weber, M.-A.; Großmann, A. Hirnvenen- und Sinusthrombose nach COVID-19-Schutzimpfung: Neurologisch-radiologisches Prozedere (Cerebral venous sinus thrombosis after COVID-19 vaccination: Neurological and radiological management). Radiologe 2021, 61, 923–932. [Google Scholar] [CrossRef]
- van de Munckhof, A.; Krzywicka, K.; Aguiar de Sousa, D.; van Sánchez Kammen, M.; Heldner, M.R.; Jood, K.; Lindgren, E.; Tatlisumak, T.; Putaala, J.; Kremer Hovinga, J.A.; et al. Declining mortality of cerebral venous sinus thrombosis with thrombocytopenia after SARS-CoV-2 vaccination. Eur. J. Neurol. 2022, 29, 339–344. [Google Scholar] [CrossRef]
- Scutelnic, A.; Krzywicka, K.; Mbroh, J.; van de Munckhof, A.; van Kammen, M.S.; de Lindgren, E.S.D.A.; Jood, K.; Günther, A.; Hiltunen, S.; Putaala, J.; et al. Management of Cerebral Venous Thrombosis Due to Adenoviral COVID-19 Vaccination. Ann. Neurol. 2022, 92, 562–573. [Google Scholar] [CrossRef]
- Kim, A.Y.; Woo, W.; Yon, D.K.; Lee, S.W.; Yang, J.W.; Kim, J.H.; Park, S.; Koyanagi, A.; Kim, M.S.; Lee, S.; et al. Thrombosis patterns and clinical outcome of COVID-19 vaccine-induced immune thrombotic thrombocyto-penia: A Systematic Review and Meta-Analysis. Int. J. Infect. Dis. 2022, 119, 130–139. [Google Scholar] [CrossRef]
- Dix, C.; McFadyen, J.; Huang, A.; Chunilal, S.; Chen, V.; Tran, H. Understanding vaccine-induced thrombotic thrombocytopenia (VITT). Intern. Med. J. 2022, 52, 717–723. [Google Scholar] [CrossRef] [PubMed]
- Furie, K.L.; Cushman, M.; Elkind, M.S.V.; Lyden, P.D.; Saposnik, G. Diagnosis and Management of Cerebral Venous Sinus Thrombosis with Vaccine-Induced Immune Thrombotic Thrombocytopenia. Stroke 2021, 52, 2478–2482. [Google Scholar] [CrossRef] [PubMed]
- Greinacher, A.; Langer, F.; Makris, M.; Pai, M.; Pavord, S.; Tran, H.; Warkentin, T.E. Vaccine-induced immune thrombotic thrombocytopenia (VITT): Update on diagnosis and management considering different resources. J. Thromb. Haemost. 2022, 20, 149–156. [Google Scholar] [CrossRef] [PubMed]
- Bussel, J.B.; Connors, J.M.; Cines, D.B.; Dunbar, C.E.; Michaelis, L.C.; Kreuziger, L.B.; Lee, A.Y.Y.; Pabinger-Fasching, I. Vaccine-induced Immune Thrombotic Thrombocytopenia. 2022. Available online: https://www.hematology.org/covid-19/vaccine-induced-immune-thrombotic-thrombocytopenia (accessed on 9 June 2023).
- Schönborn, L.; Thiele, T.; Kaderali, L.; Greinacher, A. Decline in Pathogenic Antibodies over Time in VITT. N. Engl. J. Med. 2021, 385, 1815–1816. [Google Scholar] [CrossRef] [PubMed]
- Kakovan, M.; Ghorbani Shirkouhi, S.; Zarei, M.; Andalib, S. Stroke Associated with COVID-19 Vaccines. J. Stroke Cerebrovasc. Dis. 2022, 31, 106440. [Google Scholar] [CrossRef] [PubMed]
- Warkentin, T.E.; Cuker, A. COVID-19: Vaccine-Induced Immune Thrombotic Thrombocytopenia (VITT)-UpToDate. 2023. Available online: https://www.uptodate.com/contents/covid-19-vaccine-induced-immune-thrombotic-thrombocytopenia-vitt (accessed on 9 June 2023).
- Guideline COVID-19 Rapid Guideline: Vaccine-Induced Immune Thrombocytopenia and Thrombosis (VITT). The National Institute for Health and Care Excellence (NICE). 2022. Available online: https://www.ncbi.nlm.nih.gov/books/NBK573014/pdf/Bookshelf_NBK573014.pdf (accessed on 18 April 2024).
- Winkler, P.A.; Stummer, W.; Linke, R.; Krishnan, K.G.; Tatsch, K. The influence of cranioplasty on postural blood flow regulation, cerebrovascular reserve capacity, and cerebral glucose metabolism. Neurosurg. Focus 2000, 8, e9. [Google Scholar] [CrossRef]
- Borger, V.; Schuss, P.; Kinfe, T.M.; Vatter, H.; Güresir, E. Decompressive Craniectomy for Stroke: Early Cranioplasty Is a Predictor for Postoperative Complications. World Neurosurg. 2016, 92, 83–88. [Google Scholar] [CrossRef]
- Liang, W.; Xiaofeng, Y.; Weiguo, L.; Gang, S.; Xuesheng, Z.; Fei, C.; Gu, L. Cranioplasty of large cranial defect at an early stage after decompressive craniectomy performed for severe head trauma. J. Craniofac. Surg. 2007, 18, 526–532. [Google Scholar] [CrossRef] [PubMed]
- Schuss, P.; Vatter, H.; Marquardt, G.; Imöhl, L.; Ulrich, C.T.; Seifert, V.; Güresir, E. Cranioplasty after decompressive craniectomy: The effect of timing on postoperative complications. J. Neurotrauma 2012, 29, 1090–1095. [Google Scholar] [CrossRef]
- Gessler, F.; Schmitz, A.K.; Dubinski, D.; Bernstock, J.D.; Lehmann, F.; Won, S.-Y.; Wittstock, M.; Güresir, E.; Hadjiathanasiou, A.; Zimmermann, J.; et al. Neurosurgical Considerations Regarding Decompressive Craniectomy for Intracerebral Hemorrhage after SARS-CoV-2-Vaccination in Vaccine Induced Thrombotic Thrombocytopenia-VITT. J. Clin. Med. 2021, 10, 2777. [Google Scholar] [CrossRef]
- Goel, R.; Ness, P.M.; Takemoto, C.M.; Krishnamurti, L.; King, K.E.; Tobian, A.A.R. Platelet transfusions in platelet consumptive disorders are associated with arterial thrombosis and in-hospital mortality. Blood 2015, 125, 1470–1476. [Google Scholar] [CrossRef] [PubMed]
Characteristic | |
---|---|
SARS-CoV-2 vaccine | Ad26.COV2.S |
age (years) | 29 |
sex | male |
medical history | - |
medication prior to ictus | - |
time from vaccination to admission (days) | 12 |
time between DC and cranioplasty (months) | 6 |
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Spanehl, L.; Walter, U.; Thiele, T.; Dubinski, D.; Behmanesh, B.; Freiman, T.M.; Wittstock, M.; Schuss, P.; Vatter, H.; Schneider, M.; et al. Cranioplasty after Decompressive Craniectomy (DC) in a Patient with Intracerebral Hemorrhage after SARS-CoV-2 Vaccination-Related Vaccine-Induced Thrombotic Thrombocytopenia (VITT)—Proposal of a Management Protocol for This Rare Pathological Condition. J. Clin. Med. 2024, 13, 4778. https://doi.org/10.3390/jcm13164778
Spanehl L, Walter U, Thiele T, Dubinski D, Behmanesh B, Freiman TM, Wittstock M, Schuss P, Vatter H, Schneider M, et al. Cranioplasty after Decompressive Craniectomy (DC) in a Patient with Intracerebral Hemorrhage after SARS-CoV-2 Vaccination-Related Vaccine-Induced Thrombotic Thrombocytopenia (VITT)—Proposal of a Management Protocol for This Rare Pathological Condition. Journal of Clinical Medicine. 2024; 13(16):4778. https://doi.org/10.3390/jcm13164778
Chicago/Turabian StyleSpanehl, Lennard, Uwe Walter, Thomas Thiele, Daniel Dubinski, Bedjan Behmanesh, Thomas M. Freiman, Matthias Wittstock, Patrick Schuss, Hartmut Vatter, Matthias Schneider, and et al. 2024. "Cranioplasty after Decompressive Craniectomy (DC) in a Patient with Intracerebral Hemorrhage after SARS-CoV-2 Vaccination-Related Vaccine-Induced Thrombotic Thrombocytopenia (VITT)—Proposal of a Management Protocol for This Rare Pathological Condition" Journal of Clinical Medicine 13, no. 16: 4778. https://doi.org/10.3390/jcm13164778