Five cases of cerebrospinal fluid leakage in adolescents following COVID-19 vaccine
2023 Volume 48 Issue 1 Pages 65-70
Details
2023 Volume 48 Issue 1 Pages 65-70
This study investigated CSF leak that occurred in five adolescents (3 males, 2 females) following COVID-19 vaccination. Mean patient age was 15.6 years (range, 14-17 years) at onset. CSF leakage was diagnosed based on the findings of CT myelography and radioisotope (RI) cisternography in one case, and by the effectiveness of epidural physiological saline injection in the remaining four cases.
All patients had received the Comirnaty vaccine (BNT162b2, BioNTech/Pfizer) and experienced one or more symptoms such as intractable headache, vertigo, fatigue, or visual disturbance. All patients underwent neurological examinations but a diagnosis was not reached in any case.Some cases were diagnosed as mental problem. Three patients were completely disabled following vaccination and unable to carry out any self-care, one was capable of only limited self-care, and one was unable to perform any work activities.
Subsequent treatment with an epidural blood patch (EBP) was effective in all cases. Three patients (60.0%) completely recovered to full unrestricted activity at pre-disease levels, and two patients (40.0%) achieved partial recovery. In patients who experience various intractable symptoms such as headache after COVID-19 vaccination and in whom treatment is ineffective, CSF leakage should be considered in the differential diagnosis.
