PMC8498326_01
(A) Magnetic resonance venography showed loss of signal in the left transverse sinus, sigmoid sinus, and left distal internal jugular vein (red arrow), which were consistent with dural venous sinus thrombosis at 10 days post-vaccination. (B). Magnetic resonance venography after 2 months of direct oral anticoagulant (10 mg apixaban twice daily for initial 7 days, 5 mg twice daily for the following 2 months) showed patent left transverse sinus, sigmoid sinus, and left distal internal jugular vein (red arrow), indicative of recanalization and disease regression. (C) Computed tomography showed a filling defect in the left upper lung (red arrow), consistent with pulmonary embolism.
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F1
Magnetic resonance imaging (MRI) of the brain showed dural sinus thrombosis in the left transverse sinus, sigmoid sinus, and left distal internal jugular vein (Figure 1A). Chest computed tomography (CT) scan showed filling defects in the left upper lobe, suggesting pulmonary embolism (Figure 1C). Following brain magnetic resonance venography after DOAC usage for 2 months (10 mg apixaban twice daily for initial 7 days, 5 mg twice daily for the following 2 months) showed patent left transverse sinus, sigmoid sinus, and left distal internal jugular vein, consistent with recanalization and disease regression (Figure 1B).
Serial serum platelet count post-vaccination and chronological evolution of symptoms after steroid treatment and high-dose immunoglobulin.
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F2
The platelet count, D-dimer level, and the patient's clinical symptoms gradually improved (Figure 2); he was discharged, without sequelae, 10 days after admission to the hospital.