Sex: M
Vaccine: COVID19, COVID19
Symptoms: COVID-19 immunisation, Cerebral venous sinus thrombosis, Computerised tomogram head, Computerised tomogram venography head
Clinical narrative: CEREBRAL VENOUS SINUS THROMBOSIS (CVST); REVACCINATION WITH DIFFERENT COVID-19 VACCINE; This spontaneous report was received from literature: This report concerned a 34 year old male. The patient's height, and weight were not reported. The patient's pre-existing medical conditions included: He denied other neurological symptoms, trauma, recent illnesses, similar headaches in the past, or a family history of hematological disorders. The patient received covid-19 vaccine ad26.cov2.s (dose series 1) (suspension for injection, intramuscular, batch number was not reported) dose, start therapy date were not reported for covid-19 prophylaxis. Non-company suspect vaccine included: covid-19 vaccine (dose series 2) (form of admin, route of admin, and batch number were not reported), dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported. The Company is unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. A previously healthy patient presented two weeks after his second mRNA COVID-19 vaccine dose with a sudden-onset headache. He described it as a pressure-like sensation in the bilateral frontal and parietal regions associated with positional changes, nausea, and vomiting. He denied other neurological symptoms, trauma, recent illnesses, similar headaches in the past, or a family history of hematological disorders. He tried acetaminophen but found no relief. On presentation, he was hemodynamically stable, and basic laboratory workup was unremarkable. A CT brain without contrast revealed hyperdense superior sagittal sinuses, and a subsequent CT Venogram confirmed dural venous sinus thrombosis in the superior sagittal, right transverse, and sigmoid sinuses. Anticoagulation with apixaban was initiated, and he was referred to hematology, which identified a Factor V Leiden heterozygous mutation. Due to the increased relative risk associated with this mutation and the atypical thrombus location, indefinite anticoagulation at a maintenance dose for secondary prophylaxis was recommended. Unfortunately, he experienced another CVST (Cerebral venous sinus thrombosis) (dose series 2) episode eight months later due to non-compliance with anticoagulation therapy. On an unspecified date, the patient experienced revaccination with different covid-19 vaccine (dose series 2).  The action taken with covid-19 vaccine ad26.cov2.s, and covid-19 vaccine was not applicable. The outcome of the cerebral venous sinus thrombosis (cvst) and revaccination with different covid-19 vaccine was not reported. This report was serious (Other Medically Important Condition). This case, involving the same patient is linked to 20240655583.; Sender's Comments: 000-. The event has an unknown/unclear temporal relationship, and is labeled. There are other factors more likely to be associated with the event. Specifically: CONMEDS-OTHER SUSPECT DRUGS( Mrna vaccine), MEDICAL HISTORY( Factor 5  leiden mutation) . Therefore, this event is considered inconsistent with vaccine administration.