An Autopsy Case of Reversible Cerebral Vasoconstriction Syndrome After a Severe Acute Respiratory Syndrome Coronavirus 2 Vaccination

Mai Shimura; Hirohisa Fujikawa; Masanobu Yazawa; Yuki Matsumoto; Mitsunori Yamada

doi:10.7759/cureus.59311

An Autopsy Case of Reversible Cerebral Vasoconstriction Syndrome After a Severe Acute Respiratory Syndrome Coronavirus 2 Vaccination

Cureus. 2024 Apr 29;16(4):e59311. doi: 10.7759/cureus.59311. eCollection 2024 Apr.

Authors

Mai Shimura^{1

2}, Hirohisa Fujikawa^{3

4}, Masanobu Yazawa², Yuki Matsumoto⁵, Mitsunori Yamada⁶

Affiliations

¹ Department of Medical Oncology, National Cancer Center Hospital East, Chiba, JPN.
² Department of Internal Medicine, Fujimi-Kogen Hospital, Fujimi-Kogen Medical Center, Nagano, JPN.
³ Center for General Medicine Education, School of Medicine, Keio University, Tokyo, JPN.
⁴ Department of Internal Medicine, Suwa Central Hospital, Nagano, JPN.
⁵ Department of Pathology, Shinshu University School of Medicine, Nagano, JPN.
⁶ Department of Brain Disease Research, Shinshu University School of Medicine, Nagano, JPN.

Abstract

A 73-year-old man with chronic obstructive pulmonary disease received the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mRNA vaccine. The following day, the patient developed a headache, followed by a tonic-clonic seizure and decreased consciousness. Magnetic resonance imaging of the head revealed no signs of stroke but multiple vasoconstrictions. Despite antiepileptic therapy, the seizure persisted, and the patient died 40 hours after vaccination. An autopsy revealed multiple brain ischemia without any vascular lesions, suggesting reversible cerebral vasoconstriction syndrome (RCVS). In this case, RCVS was diagnosed radiographically and pathologically. Our case suggests that RCVS could be a cause of headache and epilepsy following the SARS-CoV-2 mRNA vaccination.

Keywords: autopsy; covid-19; epilepsy; headache; rcvs; sars-cov-2 vaccination.

Publication types

Case Reports