Cerebral venous thrombosis without vaccine-induced immune thrombotic thrombocytopenia following BNT162b2 mRNA Covid-19 vaccine: a case report

Cerebral venous thrombosis is a rare but serious condition that has been reported following Covid-19 vaccination, particularly after adenoviral vector vaccines. However, cases following mRNA vaccines such as BNT162b2 are much less common, and most do not involve vaccine induced immune thrombotic thrombocytopenia. We report the case of 59-year-old woman from Morocco, who was admitted to our hospital 18 days after receiving her first dose of BNT162b2 mRNA Covid-19 vaccine corresponding to the third dose of her Covid-19 vaccine (Previous two doses were ChAdOx1 vaccine). 15 days after vaccination, she developed vomiting and a severe persistent headache, followed by low back pain. Unfortunately, she died from cerebral venous thrombosis without vaccine induced immune thrombotic thrombocytopenia complicated by a massive intracerebral hemorrhage 35 days following vaccination. The occurrence of cerebral venous thrombosis, particularly cerebral venous thrombosis without vaccine induced immune thrombotic thrombocytopenia, following BNT162b2 mRNA vaccination remains extremely rare. This case underscores the need for clinicians to be aware that cerebral venous thrombosis can occur independently of vaccine induced immune thrombotic thrombocytopenia.