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ArticleNeurology(R) neuroimmunology & neuroinflammation2023

Immunohistologic Features of Cerebral Venous Thrombosis Due to Vaccine-Induced Immune Thrombotic Thrombocytopenia.

Thomas Geeraerts, Céline Guilbeau-Frugier, Cédric Garcia, Vincent Memier, Nicolas Raposo, Fabrice Bonneville, Céline Gales, Jean Darcourt, Sophie Voisin, Agnès Ribes and 11 more

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Article in Neurology(R) neuroimmunology & neuroinflammation, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it

0cells of the map it votes in

6citing papers in PubMed

2.5field-weighted citation impact, top 11% of its field

1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 8 citations in OpenAlex.

Solving the mystery of vaccine-induced immune thrombocytopenia and thrombosis.Nature reviews. Cardiology · 2026
Article
Detection of Vaccine-Derived Spike Protein Associated with Immune Cell Infiltration in the Heart and Liver: A Report of Two Cases.Cells · 2026
Article
Platelet spleen tyrosine kinase is a key regulator of anti-PF4 antibody-induced immunothrombosis.Blood advances · 2025
Article
Advances in our understanding of anti-PF4 related immunothrombosis.Frontiers in immunology · 2025
Review
The Biodistribution of the Spike Protein after Ad26.COV2.S Vaccination Is Unlikely to Play a Role in Vaccine-Induced Immune Thrombotic Thrombocytopenia.Vaccines · 2024
Article
'Spikeopathy': COVID-19 Spike Protein Is Pathogenic, from Both Virus and Vaccine mRNA.Biomedicines · 2023
Review

4 · The record

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5 · Who and what money

Authors and funding

21 authors at 1 institution in 2 countries.

Thomas GeeraertsFrom the Department of Anesthesiology and Critical Care (T.G., F. Bounes); Department of Forensic Medicine (C.G.-F., C. Gales, N.T.), Toulouse University Hospital; Institute of Metabolic and Cardiovascular Diseases (C. Garcia, A.R., B.P.), Inserm UMR-1297; Hematology Laboratory (C. Garcia, V.M., S.V., A.R., P.S., B.P.); Department of Neurology (N.R., J.F.A., J.M.O.); Department of Neuroradiology (F. Bonneville, J.D.); Department of Internal Medicine (M.P.-J.); Department of Neurosurgery (F.R.); Department of Virology (J.I.), Toulouse University Hospital, France; Department of Neuroimmunology (J.B.), Center for Brain Research, Medical University of Vienna, Austria; and Department of Immunology (R.S.L.), Toulouse University Hospital, France.

Céline Guilbeau-FrugierFrom the Department of Anesthesiology and Critical Care (T.G., F. Bounes); Department of Forensic Medicine (C.G.-F., C. Gales, N.T.), Toulouse University Hospital; Institute of Metabolic and Cardiovascular Diseases (C. Garcia, A.R., B.P.), Inserm UMR-1297; Hematology Laboratory (C. Garcia, V.M., S.V., A.R., P.S., B.P.); Department of Neurology (N.R., J.F.A., J.M.O.); Department of Neuroradiology (F. Bonneville, J.D.); Department of Internal Medicine (M.P.-J.); Department of Neurosurgery (F.R.); Department of Virology (J.I.), Toulouse University Hospital, France; Department of Neuroimmunology (J.B.), Center for Brain Research, Medical University of Vienna, Austria; and Department of Immunology (R.S.L.), Toulouse University Hospital, France.

Cédric GarciaFrom the Department of Anesthesiology and Critical Care (T.G., F. Bounes); Department of Forensic Medicine (C.G.-F., C. Gales, N.T.), Toulouse University Hospital; Institute of Metabolic and Cardiovascular Diseases (C. Garcia, A.R., B.P.), Inserm UMR-1297; Hematology Laboratory (C. Garcia, V.M., S.V., A.R., P.S., B.P.); Department of Neurology (N.R., J.F.A., J.M.O.); Department of Neuroradiology (F. Bonneville, J.D.); Department of Internal Medicine (M.P.-J.); Department of Neurosurgery (F.R.); Department of Virology (J.I.), Toulouse University Hospital, France; Department of Neuroimmunology (J.B.), Center for Brain Research, Medical University of Vienna, Austria; and Department of Immunology (R.S.L.), Toulouse University Hospital, France.ORCID 0000-0003-1566-3846

Vincent MemierFrom the Department of Anesthesiology and Critical Care (T.G., F. Bounes); Department of Forensic Medicine (C.G.-F., C. Gales, N.T.), Toulouse University Hospital; Institute of Metabolic and Cardiovascular Diseases (C. Garcia, A.R., B.P.), Inserm UMR-1297; Hematology Laboratory (C. Garcia, V.M., S.V., A.R., P.S., B.P.); Department of Neurology (N.R., J.F.A., J.M.O.); Department of Neuroradiology (F. Bonneville, J.D.); Department of Internal Medicine (M.P.-J.); Department of Neurosurgery (F.R.); Department of Virology (J.I.), Toulouse University Hospital, France; Department of Neuroimmunology (J.B.), Center for Brain Research, Medical University of Vienna, Austria; and Department of Immunology (R.S.L.), Toulouse University Hospital, France.ORCID 0000-0002-9912-2846

Nicolas RaposoFrom the Department of Anesthesiology and Critical Care (T.G., F. Bounes); Department of Forensic Medicine (C.G.-F., C. Gales, N.T.), Toulouse University Hospital; Institute of Metabolic and Cardiovascular Diseases (C. Garcia, A.R., B.P.), Inserm UMR-1297; Hematology Laboratory (C. Garcia, V.M., S.V., A.R., P.S., B.P.); Department of Neurology (N.R., J.F.A., J.M.O.); Department of Neuroradiology (F. Bonneville, J.D.); Department of Internal Medicine (M.P.-J.); Department of Neurosurgery (F.R.); Department of Virology (J.I.), Toulouse University Hospital, France; Department of Neuroimmunology (J.B.), Center for Brain Research, Medical University of Vienna, Austria; and Department of Immunology (R.S.L.), Toulouse University Hospital, France.ORCID 0000-0002-9152-4445

Fabrice BonnevilleFrom the Department of Anesthesiology and Critical Care (T.G., F. Bounes); Department of Forensic Medicine (C.G.-F., C. Gales, N.T.), Toulouse University Hospital; Institute of Metabolic and Cardiovascular Diseases (C. Garcia, A.R., B.P.), Inserm UMR-1297; Hematology Laboratory (C. Garcia, V.M., S.V., A.R., P.S., B.P.); Department of Neurology (N.R., J.F.A., J.M.O.); Department of Neuroradiology (F. Bonneville, J.D.); Department of Internal Medicine (M.P.-J.); Department of Neurosurgery (F.R.); Department of Virology (J.I.), Toulouse University Hospital, France; Department of Neuroimmunology (J.B.), Center for Brain Research, Medical University of Vienna, Austria; and Department of Immunology (R.S.L.), Toulouse University Hospital, France.

Céline GalesFrom the Department of Anesthesiology and Critical Care (T.G., F. Bounes); Department of Forensic Medicine (C.G.-F., C. Gales, N.T.), Toulouse University Hospital; Institute of Metabolic and Cardiovascular Diseases (C. Garcia, A.R., B.P.), Inserm UMR-1297; Hematology Laboratory (C. Garcia, V.M., S.V., A.R., P.S., B.P.); Department of Neurology (N.R., J.F.A., J.M.O.); Department of Neuroradiology (F. Bonneville, J.D.); Department of Internal Medicine (M.P.-J.); Department of Neurosurgery (F.R.); Department of Virology (J.I.), Toulouse University Hospital, France; Department of Neuroimmunology (J.B.), Center for Brain Research, Medical University of Vienna, Austria; and Department of Immunology (R.S.L.), Toulouse University Hospital, France.

Jean DarcourtFrom the Department of Anesthesiology and Critical Care (T.G., F. Bounes); Department of Forensic Medicine (C.G.-F., C. Gales, N.T.), Toulouse University Hospital; Institute of Metabolic and Cardiovascular Diseases (C. Garcia, A.R., B.P.), Inserm UMR-1297; Hematology Laboratory (C. Garcia, V.M., S.V., A.R., P.S., B.P.); Department of Neurology (N.R., J.F.A., J.M.O.); Department of Neuroradiology (F. Bonneville, J.D.); Department of Internal Medicine (M.P.-J.); Department of Neurosurgery (F.R.); Department of Virology (J.I.), Toulouse University Hospital, France; Department of Neuroimmunology (J.B.), Center for Brain Research, Medical University of Vienna, Austria; and Department of Immunology (R.S.L.), Toulouse University Hospital, France.ORCID 0000-0003-1620-4449

Sophie VoisinFrom the Department of Anesthesiology and Critical Care (T.G., F. Bounes); Department of Forensic Medicine (C.G.-F., C. Gales, N.T.), Toulouse University Hospital; Institute of Metabolic and Cardiovascular Diseases (C. Garcia, A.R., B.P.), Inserm UMR-1297; Hematology Laboratory (C. Garcia, V.M., S.V., A.R., P.S., B.P.); Department of Neurology (N.R., J.F.A., J.M.O.); Department of Neuroradiology (F. Bonneville, J.D.); Department of Internal Medicine (M.P.-J.); Department of Neurosurgery (F.R.); Department of Virology (J.I.), Toulouse University Hospital, France; Department of Neuroimmunology (J.B.), Center for Brain Research, Medical University of Vienna, Austria; and Department of Immunology (R.S.L.), Toulouse University Hospital, France.

Agnès RibesFrom the Department of Anesthesiology and Critical Care (T.G., F. Bounes); Department of Forensic Medicine (C.G.-F., C. Gales, N.T.), Toulouse University Hospital; Institute of Metabolic and Cardiovascular Diseases (C. Garcia, A.R., B.P.), Inserm UMR-1297; Hematology Laboratory (C. Garcia, V.M., S.V., A.R., P.S., B.P.); Department of Neurology (N.R., J.F.A., J.M.O.); Department of Neuroradiology (F. Bonneville, J.D.); Department of Internal Medicine (M.P.-J.); Department of Neurosurgery (F.R.); Department of Virology (J.I.), Toulouse University Hospital, France; Department of Neuroimmunology (J.B.), Center for Brain Research, Medical University of Vienna, Austria; and Department of Immunology (R.S.L.), Toulouse University Hospital, France.

Marie Piel-JulianFrom the Department of Anesthesiology and Critical Care (T.G., F. Bounes); Department of Forensic Medicine (C.G.-F., C. Gales, N.T.), Toulouse University Hospital; Institute of Metabolic and Cardiovascular Diseases (C. Garcia, A.R., B.P.), Inserm UMR-1297; Hematology Laboratory (C. Garcia, V.M., S.V., A.R., P.S., B.P.); Department of Neurology (N.R., J.F.A., J.M.O.); Department of Neuroradiology (F. Bonneville, J.D.); Department of Internal Medicine (M.P.-J.); Department of Neurosurgery (F.R.); Department of Virology (J.I.), Toulouse University Hospital, France; Department of Neuroimmunology (J.B.), Center for Brain Research, Medical University of Vienna, Austria; and Department of Immunology (R.S.L.), Toulouse University Hospital, France.

Fanny BounesFrom the Department of Anesthesiology and Critical Care (T.G., F. Bounes); Department of Forensic Medicine (C.G.-F., C. Gales, N.T.), Toulouse University Hospital; Institute of Metabolic and Cardiovascular Diseases (C. Garcia, A.R., B.P.), Inserm UMR-1297; Hematology Laboratory (C. Garcia, V.M., S.V., A.R., P.S., B.P.); Department of Neurology (N.R., J.F.A., J.M.O.); Department of Neuroradiology (F. Bonneville, J.D.); Department of Internal Medicine (M.P.-J.); Department of Neurosurgery (F.R.); Department of Virology (J.I.), Toulouse University Hospital, France; Department of Neuroimmunology (J.B.), Center for Brain Research, Medical University of Vienna, Austria; and Department of Immunology (R.S.L.), Toulouse University Hospital, France.

Jean François AlbucherFrom the Department of Anesthesiology and Critical Care (T.G., F. Bounes); Department of Forensic Medicine (C.G.-F., C. Gales, N.T.), Toulouse University Hospital; Institute of Metabolic and Cardiovascular Diseases (C. Garcia, A.R., B.P.), Inserm UMR-1297; Hematology Laboratory (C. Garcia, V.M., S.V., A.R., P.S., B.P.); Department of Neurology (N.R., J.F.A., J.M.O.); Department of Neuroradiology (F. Bonneville, J.D.); Department of Internal Medicine (M.P.-J.); Department of Neurosurgery (F.R.); Department of Virology (J.I.), Toulouse University Hospital, France; Department of Neuroimmunology (J.B.), Center for Brain Research, Medical University of Vienna, Austria; and Department of Immunology (R.S.L.), Toulouse University Hospital, France.

Franck-Emmanuel RouxFrom the Department of Anesthesiology and Critical Care (T.G., F. Bounes); Department of Forensic Medicine (C.G.-F., C. Gales, N.T.), Toulouse University Hospital; Institute of Metabolic and Cardiovascular Diseases (C. Garcia, A.R., B.P.), Inserm UMR-1297; Hematology Laboratory (C. Garcia, V.M., S.V., A.R., P.S., B.P.); Department of Neurology (N.R., J.F.A., J.M.O.); Department of Neuroradiology (F. Bonneville, J.D.); Department of Internal Medicine (M.P.-J.); Department of Neurosurgery (F.R.); Department of Virology (J.I.), Toulouse University Hospital, France; Department of Neuroimmunology (J.B.), Center for Brain Research, Medical University of Vienna, Austria; and Department of Immunology (R.S.L.), Toulouse University Hospital, France.

Jacques IzopetFrom the Department of Anesthesiology and Critical Care (T.G., F. Bounes); Department of Forensic Medicine (C.G.-F., C. Gales, N.T.), Toulouse University Hospital; Institute of Metabolic and Cardiovascular Diseases (C. Garcia, A.R., B.P.), Inserm UMR-1297; Hematology Laboratory (C. Garcia, V.M., S.V., A.R., P.S., B.P.); Department of Neurology (N.R., J.F.A., J.M.O.); Department of Neuroradiology (F. Bonneville, J.D.); Department of Internal Medicine (M.P.-J.); Department of Neurosurgery (F.R.); Department of Virology (J.I.), Toulouse University Hospital, France; Department of Neuroimmunology (J.B.), Center for Brain Research, Medical University of Vienna, Austria; and Department of Immunology (R.S.L.), Toulouse University Hospital, France.

Norbert TelmonFrom the Department of Anesthesiology and Critical Care (T.G., F. Bounes); Department of Forensic Medicine (C.G.-F., C. Gales, N.T.), Toulouse University Hospital; Institute of Metabolic and Cardiovascular Diseases (C. Garcia, A.R., B.P.), Inserm UMR-1297; Hematology Laboratory (C. Garcia, V.M., S.V., A.R., P.S., B.P.); Department of Neurology (N.R., J.F.A., J.M.O.); Department of Neuroradiology (F. Bonneville, J.D.); Department of Internal Medicine (M.P.-J.); Department of Neurosurgery (F.R.); Department of Virology (J.I.), Toulouse University Hospital, France; Department of Neuroimmunology (J.B.), Center for Brain Research, Medical University of Vienna, Austria; and Department of Immunology (R.S.L.), Toulouse University Hospital, France.

Jean Marc OlivotFrom the Department of Anesthesiology and Critical Care (T.G., F. Bounes); Department of Forensic Medicine (C.G.-F., C. Gales, N.T.), Toulouse University Hospital; Institute of Metabolic and Cardiovascular Diseases (C. Garcia, A.R., B.P.), Inserm UMR-1297; Hematology Laboratory (C. Garcia, V.M., S.V., A.R., P.S., B.P.); Department of Neurology (N.R., J.F.A., J.M.O.); Department of Neuroradiology (F. Bonneville, J.D.); Department of Internal Medicine (M.P.-J.); Department of Neurosurgery (F.R.); Department of Virology (J.I.), Toulouse University Hospital, France; Department of Neuroimmunology (J.B.), Center for Brain Research, Medical University of Vienna, Austria; and Department of Immunology (R.S.L.), Toulouse University Hospital, France.ORCID 0000-0003-2027-2276

Pierre SiéFrom the Department of Anesthesiology and Critical Care (T.G., F. Bounes); Department of Forensic Medicine (C.G.-F., C. Gales, N.T.), Toulouse University Hospital; Institute of Metabolic and Cardiovascular Diseases (C. Garcia, A.R., B.P.), Inserm UMR-1297; Hematology Laboratory (C. Garcia, V.M., S.V., A.R., P.S., B.P.); Department of Neurology (N.R., J.F.A., J.M.O.); Department of Neuroradiology (F. Bonneville, J.D.); Department of Internal Medicine (M.P.-J.); Department of Neurosurgery (F.R.); Department of Virology (J.I.), Toulouse University Hospital, France; Department of Neuroimmunology (J.B.), Center for Brain Research, Medical University of Vienna, Austria; and Department of Immunology (R.S.L.), Toulouse University Hospital, France.

Jan BauerFrom the Department of Anesthesiology and Critical Care (T.G., F. Bounes); Department of Forensic Medicine (C.G.-F., C. Gales, N.T.), Toulouse University Hospital; Institute of Metabolic and Cardiovascular Diseases (C. Garcia, A.R., B.P.), Inserm UMR-1297; Hematology Laboratory (C. Garcia, V.M., S.V., A.R., P.S., B.P.); Department of Neurology (N.R., J.F.A., J.M.O.); Department of Neuroradiology (F. Bonneville, J.D.); Department of Internal Medicine (M.P.-J.); Department of Neurosurgery (F.R.); Department of Virology (J.I.), Toulouse University Hospital, France; Department of Neuroimmunology (J.B.), Center for Brain Research, Medical University of Vienna, Austria; and Department of Immunology (R.S.L.), Toulouse University Hospital, France.

Bernard PayrastreFrom the Department of Anesthesiology and Critical Care (T.G., F. Bounes); Department of Forensic Medicine (C.G.-F., C. Gales, N.T.), Toulouse University Hospital; Institute of Metabolic and Cardiovascular Diseases (C. Garcia, A.R., B.P.), Inserm UMR-1297; Hematology Laboratory (C. Garcia, V.M., S.V., A.R., P.S., B.P.); Department of Neurology (N.R., J.F.A., J.M.O.); Department of Neuroradiology (F. Bonneville, J.D.); Department of Internal Medicine (M.P.-J.); Department of Neurosurgery (F.R.); Department of Virology (J.I.), Toulouse University Hospital, France; Department of Neuroimmunology (J.B.), Center for Brain Research, Medical University of Vienna, Austria; and Department of Immunology (R.S.L.), Toulouse University Hospital, France.ORCID 0000-0002-8693-0190

Roland S LiblauFrom the Department of Anesthesiology and Critical Care (T.G., F. Bounes); Department of Forensic Medicine (C.G.-F., C. Gales, N.T.), Toulouse University Hospital; Institute of Metabolic and Cardiovascular Diseases (C. Garcia, A.R., B.P.), Inserm UMR-1297; Hematology Laboratory (C. Garcia, V.M., S.V., A.R., P.S., B.P.); Department of Neurology (N.R., J.F.A., J.M.O.); Department of Neuroradiology (F. Bonneville, J.D.); Department of Internal Medicine (M.P.-J.); Department of Neurosurgery (F.R.); Department of Virology (J.I.), Toulouse University Hospital, France; Department of Neuroimmunology (J.B.), Center for Brain Research, Medical University of Vienna, Austria; and Department of Immunology (R.S.L.), Toulouse University Hospital, France. roland.liblau@inserm.fr.

Inserm · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesVaccine-induced immune thrombotic thrombocytopenia (VITT), a recently described entity characterized by thrombosis at unusual locations such as cerebral venous sinus and splanchnic vein, has been rarely described after adenoviral-encoded COVID-19 vaccines. In this study, we report the immunohistological correlates in 3 fatal cases of cerebral venous thrombosis related to VITT analyzed at an academic medical center.

methodsDetailed neuropathologic studies were performed in 3 cases of cerebral venous thrombosis related to VITT after adenoviral COVID-19 vaccination.

resultsAutopsy revealed extensive cerebral vein thrombosis in all 3 cases. Polarized thrombi were observed with a high density of neutrophils in the core and a low density in the tail. Endothelial cells adjacent to the thrombus were largely destroyed. Markers of neutrophil extracellular trap and complement activation were present at the border and within the cerebral vein thrombi. SARS-CoV-2 spike protein was detected within the thrombus and in the adjacent vessel wall. DISCUSSION: Data indicate that neutrophils and complement activation associated with antispike immunity triggered by the vaccine is probably involved in the disease process.

Indexed as

COVID-19ThrombocytopeniaThrombosisVaccinesVenous ThrombosisCOVID-19 VaccinesEndothelial CellsHumansSARS-CoV-2Spike Glycoprotein, CoronavirusCOVID-19 VaccinesSpike Glycoprotein, Coronavirusspike protein, SARS-CoV-2Vaccines

Identifiers

PMID37236806

DOI10.1212/NXI.0000000000200127

PMCPMC10219108

OpenAlexW4378373372

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