摘要
本文由一個案例報告為引子，介紹腦靜脈竇栓塞此一神經學急症，並說明疫苗誘發血栓性血小板低下症候群（vaccine-induced immune thrombotic thrombocytopenia, VITT），此種少見但可能致命的新冠肺炎疫苗相關不良反應。新冠肺炎疫苗誘發免疫反應導致血栓形成及血小板低下，根據血栓形成部位的不同，造成不同的臨床症狀，嚴重時可能致死，須臨床醫療人員保持高度警覺。治療上以使用抗凝血藥物與高劑量免疫球蛋白為主軸，搭配支持性療法。
參考文獻
Idiculla PS, Gurala D, Palanisamy M, et al. Cerebral Venous Thrombosis: A Comprehensive Review. Eur Neurol 2020;83:369-79.
Saposnik G, Barinagarrementeria F, Brown RD Jr, et al. Diagnosis and management of cerebral venous thrombosis: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2011;42:1158-92.
McCullough-Hicks ME, Halterman DJ, Anderson D, et al. High Incidence and Unique Features of Cerebral Venous Sinus Thrombosis in Hospitalized Patients With COVID-19 Infection. Stroke 2022;53:e407-10.
Stam J. Thrombosis of the cerebral veins and sinuses. N Engl J Med 2005;352:1791-8.
B.Nazy I, Sachs UJ, Arnold DM, et al. Recommendations for the clinical and laboratory diagnosis of VITT against COVID-19: Communication from the ISTH SSC Subcommittee on Platelet Immunology. J Thromb Haemost 2021;19:1585-8.