28 minutes | Apr 16, 2021

45. The Story Behind COVID Vaccines and Brain Blood Clots

The news this week has been replete with stories about increased clot risk in those who have received the AstraZeneca and Johnson & Johnson COVID-19 vaccines. In this episode, we break down: what we know so far about vaccine induced thrombotic thrombocytopenia (VITT), the research that has revealed an underlying mechanism, CDC and NHS recommendations, and a primer on cerebral venous thrombosis -- the primary clot site associated with VITT. We Discuss: Vaccine induced thrombotic thrombocytopenia (VITT) The similar mechanism of AstraZeneca's and Johnson & Johnson's COVID-19 vaccines [01:00]; Proposed mechanism of VITT [03:20]; Types of clots associated with VITT [04:00]; Incidence of VITT in the US and UK [05:00]; The CDC and NHS rallying cry to treat this differently that other causes of cerebral venous thrombosis (CVT) [06:30]; The UK algorithm for evaluating and managing patients with suspected VITT [08:00]; A primer on CVT Why CVT can cause problems [10:30] Presenting symptoms of CVT [11:00] Physical exam findings and the sensitivity of papilledema [15:00] Using D-dimer in the evaluation of CVT [16:50]; A new clinical score for CVT [19:00]; Utility of spinal tap as a rule out test [21:00]; Imaging options (CT venogram vs MR venogram) [22:00]; CDC treatment recommendations for  VITT associated CVT and how it’s different than most other CVT’s [25:00]; Testing patients with VITT for heparin-PF4 antibodies and how that may guide whether or not to use IVIG [26:35]. For complete and detailed show notes, previous episodes, or to sign up for our newsletter: https://www.stimuluspodcast.com/ If you like what you hear on Stimulus and use Apple/iTunes as your podcatcher, please consider leaving a review of the show. I read all the reviews and, more importantly, so do potential guests. Thanks in advance! Interested in sponsoring this podcast? Connect with us here Follow Rob: Twitter: https://twitter.com/emergencypdx Facebook: https://www.facebook.com/stimuluswithrobormanmd Youtube: https://www.youtube.com/c/emergencypdx
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