Publications by authors named "Anita van de Munckhof"
Article Synopsis
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- The DOI number given is 10.3389/fneur.2023.1251581.
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Introduction: Previous reports and meta-analyses derived from small case series reported a mortality rate of up to 40% in patients with coronavirus disease 2019 associated cerebral venous thrombosis (COVID-CVT). We assessed the clinical characteristics and outcomes in an international cohort of patients with COVID-CVT.
Patients And Methods: This was a registry study of consecutive COVID-CVT patients diagnosed between March 2020 and March 2023.
Article Synopsis
- The text outlines the challenges of conducting research on cerebral venous thrombosis (CVT) due to its rarity, emphasizing the need for a prioritized international research agenda to enhance prevention, diagnosis, and treatment for better patient outcomes.
- The agenda was developed during a summit in June 2023, involving 45 participants from 15 countries, including clinical researchers, former CVT patients, and representatives from funding organizations, focused on key research themes.
- It categorizes essential research questions into themes like epidemiology, diagnosis, medical treatment, and more, aiming to inspire future research, foster collaboration, and help secure funding to address these critical questions in CVT.
Vaccine-induced immune thrombotic thrombocytopenia (VITT) is a rare autoimmune condition associated with recombinant adenovirus (rAV)-based COVID-19 vaccines. It is thought to arise from autoantibodies targeting platelet factor 4 (aPF4), triggered by vaccine-induced inflammation and the formation of neo-antigenic complexes between PF4 and the rAV vector. To investigate the specific induction of aPF4 by rAV-based vaccines, we examined sera from rAV vaccine recipients (AZD1222, AD26.
View Article and Find Full Text PDFBackground: Endovascular thrombectomy is standard treatment for patients with anterior circulation large vessel occlusion stroke (LVO-a). Prehospital identification of these patients would enable direct routing to an endovascular thrombectomy-capable hospital and consequently reduce time-to-endovascular thrombectomy. Electroencephalography (EEG) has previously proven to be promising for LVO-a stroke detection.
View Article and Find Full Text PDFBackground And Objectives: Endovascular thrombectomy (EVT) is standard treatment for anterior large vessel occlusion stroke (LVO-a stroke). Prehospital diagnosis of LVO-a stroke would reduce time to EVT by allowing direct transportation to an EVT-capable hospital. We aim to evaluate the diagnostic accuracy of dry electrode EEG for the detection of LVO-a stroke in the prehospital setting.
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- Current guidelines suggest treating cerebral venous thrombosis (CVT) with vitamin K antagonists (VKAs) for 3-12 months, but direct oral anticoagulants (DOACs) like dabigatran are becoming popular due to promising results in smaller studies.
- The DOAC-CVT study is an international, observational trial aiming to compare the effectiveness and safety of DOACs and VKAs in preventing recurrent blood clots after CVT, involving at least 500 patients over three years.
- The study's primary goal is to evaluate the rates of recurrent venous thrombotic events and major bleeding within six months, providing real-world insights into treatment options for CVT.
Introduction: There is little data on the role of endovascular treatment (EVT) of cerebral venous sinus thrombosis (CVST) due to vaccine-induced immune thrombotic thrombocytopenia (VITT). Here, we describe clinical characteristics and outcomes of CVST-VITT patients who were treated with EVT.
Patients And Methods: We report data from an international registry of patients who developed CVST within 28 days of SARS-CoV-2 vaccination, reported between 29 March 2021 and 6 March 2023.
Article Synopsis
- A study investigated sex differences in cerebral venous sinus thrombosis associated with vaccine-induced immune thrombotic thrombocytopenia (CVST-VITT), revealing that 77% of the patients were women.
- Women presented with more severe symptoms, such as coma and lower platelet counts, and more women underwent endovascular treatment compared to men.
- Despite these differences in presentation and treatment, the overall clinical outcomes, including complications and in-hospital mortality, were similar for both sexes.
Article Synopsis
- Adenovirus-based COVID-19 vaccines are widely used in low- and middle-income countries (LMICs), but cases of vaccine-induced cerebral venous sinus thrombosis (CVST) are rarely reported.
- A study of 228 CVST cases showed 63 from LMICs, with 51% meeting vaccine-induced immune thrombotic thrombocytopenia (VITT) criteria, compared to 62% from high-income countries (HICs).
- Although clinical manifestations were similar, in-hospital mortality was significantly lower in LMICs (23%) compared to HICs (43%), suggesting different outcomes despite similar treatment approaches.
Article Synopsis
- Cerebral venous sinus thrombosis due to vaccine-induced immune thrombotic thrombocytopenia (CVST-VITT) can lead to severe bleeding and high mortality, particularly among patients requiring decompressive surgery post-COVID vaccination.
- A study reviewed 128 CVST-VITT patients, finding that 27% underwent surgery, with a 65% in-hospital mortality rate in this group compared to 29% in non-surgical patients, highlighting factors like preoperative coma and pupillary reflex absence as key mortality predictors.
- Despite the high mortality, around 80% of the surgical survivors were functionally independent at a 6-month follow-up, indicating some potential for recovery even after critical interventions.
Background: Endovascular thrombectomy (EVT) is the standard treatment for large vessel occlusion stroke of the anterior circulation (LVO-a stroke). Approximately half of EVT-eligible patients are initially presented to hospitals that do not offer EVT. Subsequent inter-hospital transfer delays treatment, which negatively affects patients' prognosis.
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- Cerebral venous thrombosis (CVT) associated with vaccine-induced immune thrombotic thrombocytopenia (VITT) has high in-hospital mortality, but outcomes are better for those who survive hospitalization after SARS-CoV-2 vaccination.
- In a study of 107 CVT-VITT cases, 40% died during initial hospitalization, but of the 60 patients who survived, 88% achieved functional independence after a median follow-up of 150 days.
- No new thrombotic events were reported post-discharge, and only one case of major bleeding occurred, indicating a generally positive prognosis for survivors.
Article Synopsis
- The study investigates the treatment of cerebral venous thrombosis (CVT) caused by vaccine-induced immune thrombotic thrombocytopenia (VITT) following adenovirus-based COVID-19 vaccinations.
- Researchers analyzed data from 99 patients across 17 countries to assess adherence to recommended treatments, including immunomodulation and avoiding certain anticoagulants.
- While overall adherence to these treatment guidelines did not significantly impact mortality, patients who received immunomodulation showed lower mortality rates compared to those who did not.
Background And Objectives: Cerebral venous sinus thrombosis (CVST) as a part of the thrombosis and thrombocytopenia syndrome is a rare adverse drug reaction of severe acute respiratory syndrome coronavirus disease 2 (SARS-CoV-2) vaccination. Estimated background rate of CVST with thrombocytopenia is 0.1 per million per month.
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- - The study focuses on patients who developed cerebral venous sinus thrombosis (CVST) after receiving SARS-CoV-2 vaccines, specifically ChAdOx1 (Oxford-AstraZeneca) and Ad26.COV2.S (Johnson & Johnson), particularly looking at those with thrombosis with thrombocytopenia syndrome (TTS) versus those without.
- - Data was gathered from an international registry from 81 hospitals spanning 19 countries, highlighting the clinical characteristics and mortality rates of patients with CVST in relation to their vaccination status.
- - Of 116 postvaccination CVST patients, 67.2% had TTS, predominantly after the ChAdOx1 vaccine, with a notable percentage of female patients and
Article Synopsis
- High mortality rates have been seen in patients with cerebral venous sinus thrombosis (CVST) caused by vaccine-induced immune thrombotic thrombocytopenia (VITT) following adenoviral vector SARS-CoV-2 vaccinations.
- A study using the EudraVigilance database assessed cases of CVST with thrombocytopenia occurring within 28 days post-vaccination, comparing cases before and after the first scientific paper on VITT was published on March 28, 2021.
- Results showed a significant decrease in mortality rates from 47% in earlier cases to 22% in later cases for adenoviral vaccines, while no deaths occurred in CVST cases following mRNA vaccinations, highlighting improved