新型冠狀病毒疫苗接種後產生顱內靜脈竇血栓患者腦部靜脈取栓治療的實施－病例報告

Performing Venous Sinus Mechanical Thrombectomy to Treat COVID-19 Vaccine-Induced Immune Thrombotic Thrombocytopenia with Central Venous Sinus Thrombosis: A Case Report

林庭偉(Ting-Wei Lin) ； 蕭名謙(Ming-Chien Hsiao) ； 李正輝(Chen-Hui Lee) ； 呂坤木(Kun-Mu Lu) ； 陳儒廷(Ju-Ting Chen)

《台灣應用輻射與同位素雜誌》 18卷2期 (2022/06) Pp. 2191-2195

摘要

疫苗接種被認為是結束2019年冠狀病毒（The coronavirus disease-2019, COVID-19）大流行最有希望之方法，隨著接種人數的增加，陸續傳出不同廠牌疫苗在接種後，皆有發生疫苗誘發免疫血栓性血小板減少症（vaccine-induced immune thrombotic thrombocytopenia, VITT）之情形。本案例為27歲男性病患注射AZ疫苗（Astra Zeneca COVID-19）後發燒三天，燒退之後有斷斷續續右側頭痛、右眼痛之情形，持續約3週，因頭痛加劇至急診求診，期間安排電腦斷層掃描及腦部磁振造影檢查，之後執行血管攝影診斷出顱內靜脈血栓，隨即安排經導管靜脈取栓術治療，取栓後症狀明顯改善．本案例報告除針對腦部靜脈取栓治療外，亦討論非對比劑注射磁振血管攝影在患者之臨床診斷應用。

關鍵字

免疫血栓性血小板減少症 ； 經導管靜脈取栓術 ； 磁振血管攝影（磁振靜脈攝影術）

並列摘要

The vaccination is considered the most effective way to cope with the COVID-19 pandemic. With the increased number of vaccination, some rare cases of COVID-19 vaccine-induced immune thrombotic thrombocytopenia (VITT) were reported. Our case was a 27-year-old healthy male who had fever for 3 days after receipt of the AstraZeneca vaccine. After the fever subsided, he started to have right occipital, temporal and retro-orbital pain off and on for 3 weeks. He came to our emergency room due to worsening of his headache. We arranged brain CTA, MRI, angiography for him and superior sagittal sinus thrombosis was demonstrated. Then mechanical thrombectomy was performed and some foamy materials were aspirated out. His headache improved after the procedure. This case report not only reports the mechanical thrombectomy for VITT, but also emphasising the role of MR Venography (MRV) in the evaluation of the disease.

並列關鍵字

Vaccine-Induced Immune Thrombotic Thrombocytopenia ； Venous Sinus Mechanical Thrombectomy ； MR Venography

參考文獻

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