Background

There is globally well documented evidence of vaccine-induced neurological complications, in particular immune thrombocytopenia and thrombosis (VITT), which although a rare complication, is associated with ChAdOx1 adenoviral vector vaccine and has been seen in up to 15.6 per million doses.

Objective

We report and discuss a case series (n=16) of vaccine-induced neuro-imaging manifestations along with their one year follow up.

Methods

Retrospective data collection between March-June 2021; revealed vaccine-induced neuro-imaging manifestations ( N=16). 12 (75%) patients presented with VITT associated cerebral venous sinus thrombosis (CVST), 3 (19%) had acute disseminated encephalomyelitis (ADEM) and 1 (6%) developed ischaemic infarct and subarachnoid haemorrhage. On one year follow up there were 3 mortalities in patients with CVST with only 2 showing complete resolution of thrombosis and partial resolution was seen in remainder 7. Severe morbidity was seen in 2 out of 3 patients with ADEM with one mortality after a prolonged ITU stay .

Results

In our cohort, prolonged hospital stay was seen in almost all the cases (n=16) and at one year follow up we found 2 patients fully recovered , 10 partially recovered and 4 died.

Conclusions

Viral vector vaccine induced neurological complications have emerged as rare complications and can be managed effectively if diagnosed early. However, we observed prolonged hospitalisation in majority of cases and multispecialty frequent long term follow up. This follow up study further explores the aetiopathogenesis of vaccine induced complications and importance of earlier recognition and therapeutic intervention.