Age: 54.0
Sex: F
Vaccine: COVID19
Symptoms: Angiogram cerebral abnormal, Arteriovenous malformation, Asthenia, Balance disorder, Blood sodium decreased
Clinical narrative: One week after receiving the J&J Covid vaccine, on 3/29/2021 at 8:30PM I began having a severe headache and pain behind my left eye. The headache continued to worsen and about 20 minutes later I began to vomit.  I continued to vomit uncontrollably all night and the severe headache continued.  I called my PCP the next morning, 3/30/2021, and he told me to go to the ER.  I went to the ER  where they did a CT and saw that I had an AVM rupture.  I was transferred to the ER.  There they did an MRI and CT and confirmed the diagnosis.  I was transferred to the ICU.  For the next 3 days they ran tests including a brain angiogram.  The physician performing the procedure determined I needed surgery and arranged for me to be transferred for surgery. I was transported to  ICU 4/1/2021, leaving  around 10:45PM.  I arrived at after midnight.  Their neuro team saw me the next day, and doctor decided to wait a week before performing the surgery to allow the swelling in my brain to go down. I stayed in the hospital that week under the stroke watch protocol.  I had an MRI 4/7/2021 and went into surgery 4/8/2021 in the afternoon.  I was not out and back in my room until after 10:00PM.  The surgical repair was successful, but on 4/10/2021 I was unresponsive and in respiratory distress.  They rushed me to CT and found massive fluid on my brain.  My sodium level was very low as well.  I was rushed to surgery and intubated and an EVD (external ventricular drain) was placed to drain the fluid.  I regained consciousness and was extubated on 4/11/2021.  I remained in the hospital with the EVD all week.  I began developing double vision towards the end of the week.  The EVD was removed 4/17/2021 and I went home.  My sight/double vision continued to worsen at home. I required around the clock care for the first 2 weeks until I was able to walk on my own with the walker.  I was very dizzy, had vertigo, was weak, had double vision, and could not care for myself without help.  On 5/12/2021 I severe vertigo, nausea and was sick in bed all day.  I contacted my neuro surgeons office and they suggested I go to the ER.  We called an ambulance and I was taken to Medical Center. They did a CT and found things stable with a little fluid in my brain.  I was given medicine for the vertigo/dizziness and nausea and discharged.  5/5/2021 I had an appointment with  ophthalmologist, , for my double vision.  The double vision got a little better when I saw him in June, then worse again in July, August and October. He ordered a CT to see if something was going on in my brain to make the vision worse as he didn?t know why it would get worse.  I had the CT 9/8/2021.  It showed everything was stable and gave no explanation as to why the double vision got worse. I stopped seeing him as I am currently being seen by an ophthalmologist.  I had a follow up appointment with the neuro surgeon  on 9/20/2021. Doctor ordered an MRI, Vestibular Therapy and Physical Therapy for me. He also referred me to a ophthalmologist. I had the MRI on 9/25/2021 and they found a non-occlusive thrombus within the left transverse and sigmoid sinus, which was new from my prior MRI on 4/7/2021. He said he wanted to watch it and I needed to have another MRI in 3 months.  I did another MRI 12/21/2021 which showed the thrombus still there.  I went to Vestibular Therapy 9/27/2021 and that helped with the vertigo.  I also started Physical Therapy that day. I?m still currently going to physical therapy to work on my balance which is still off, my strength, and rang of motion in my arms.  My vertigo came back and I went to Vestibular Therapy again 2/10/2022. It is better again.  I went to the ophthalmologist on 9/30/2021. She referred me to an ophthalmologist that performs eye surgery to see if my double vision could be corrected through surgery. He felt surgery would correct my double vision, but he was concerned about the AVM repair and the thrombosis in my left transverse and sigmoid sinuses.  He wanted to wait until my follow up MRI and get clearance from the neuro surgeon. In October 2021 I began having heart issues.  On Oct. 20, 2021, I went to my primary care physician for an irregular and rapid heart beat.  He did an ECG which showed the irregular/skipped beat.  He put me on Metoprolol xl 50mg once per day for a month.  I followed up with an appointment on November 18, 2021.  My PCP lowered the dose to 25 mg per day.  I am still taking that because if I stop, my heart pounds and I have a rapid heart rate.   I had an MRI 12/21/202. Doctor said the thrombosis is stable and cleared me to have eye surgery. I have seen the ophthalmologist at Stanford 12/30/2021 and 1/6/2022.  My eye surgery is currently scheduled for 4/15/2022.  I have another follow up appointment with the neuro surgeon 4/25/2022.  I continue to have headaches and pains in/on my head from this daily. I am dizzy all day,  have poor balance, and decrease range of motion in my arms.