45. The Story Behind COVID Vaccines and Brain Blood Clots

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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