Received Feb 25, 2026
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| COVID19 | COVID19 (COVID19 (UNKNOWN)) | UNKNOWN MANUFACTURER | UNK | — | — |
left internal carotid artery dissection; This is a literature report for the following literature source(s). A 54-year-old female patient received COVID-19 Vaccine - Manufacturer Unknown, as dose number unknown, single (Batch/Lot number: unknown) for covid-19 immunisation. The patient's relevant medical history included: "anxiety" (unspecified if ongoing); "GERD" (unspecified if ongoing); "celiacdisease" (unspecified if ongoing); "mildCOVID-19" (unspecified if ongoing); "fatigue" (unspecified if ongoing), notes: 1-month following her COVID-19; "chest pressure" (unspecified if ongoing), notes: 1-month following her COVID-19; "shortness of breath" (unspecified if ongoing), notes: 1-month following her COVID-19; "headaches" (unspecified if ongoing), notes: 1-month following her COVID-19; "dyspnea and headaches persisted." (unspecified if ongoing); "dyspnea and headaches persisted." (unspecified if ongoing). The patient's concomitant medications were not reported. The following information was reported: CAROTID ARTERY DISSECTION (medically significant, life threatening), outcome "unknown", described as "left internal carotid artery dissection". The event "left internal carotid artery dissection" required emergency room visit. The patient underwent the following laboratory tests and procedures: Angiogram: confirmed the diagnosis.; normal; Blood electrolytes: normal; Blood thyroid stimulating hormone: normal; Chest X-ray: normal; Computerised tomogram: normal; Computerised tomogram head: normal; Electrocardiogram: normal; Enzyme level test: normal; Fibrin D dimer: normal; Full blood count: normal; Labs: unremarkable except mild neutrophilia; Magnetic resonance imaging: left internal carotid, notes: artery dissection; Neurological examination: normal; Pulmonary function test: mild obstruction. Therapeutic measures were taken as a result of carotid artery dissection. Clinical course: A 54-year-old woman with a history of anxiety, GERD, celiac disease, and mild COVID-19 presented to her primary care physician for fatigue, chest pressure, shortness of breath, and headaches 1-month following her COVID-19 diagnosis. Her follow-up chest x-ray and electrocardiogram were normal, and her symptoms were attributed to post-COVID syndrome. Follow-up studies including complete blood count, serum electrolytes, thyroid stimulating hormone, D-dimer, liver enzymes, computed tomography (CT) of the chest, and CT pulmonary angiography all returned normal. Pulmonary function test showed mild obstruction. Her dyspnea and headaches persisted. Four months after her initial COVID-19 diagnosis, the patient received mRNA vaccination. The next day, she presented to the emergency department (ED) for body aches, low grade fever, and acute worsening in headache. Her neurologic exam was normal. Labs were unremarkable except mild neutrophilia, and CT head was normal. Her symptoms were attributed to post-vaccine reaction. However, the patient continued to endorse severe headaches 3-days after ED discharge, prompting magnetic resonance imaging (MRI) for further work-up. MRI revealed left internal carotid artery dissection, and CT angiography confirmed the diagnosis. Aspirin therapy was initiated with Neurology follow-up. Discussion: As data continues to emerge regarding the pathophysiology of COVID-19, it is becoming evident that the disease is a systemic inflammatory process, in which vasculitis and hyper-coagulable states may promote cardiovascular and cerebrovascular events. Cytokine dysregulation, prothrombotic state, and endothelial damage during acute COVID-19 infection have been proposed as possible mechanisms . Spontaneous carotid artery dissection in this patient with protracted COVID-19 symptoms raises the possibility of endothelial compromise. This patient's months-long persistent headaches rapidly worsened following vaccination. We do not propose a direct link between the vaccine and dissection. Rather, we raise the likelihood of a robust immune reaction being a second trigger in the setting of compromised vascular endothelium due to an initial COVID-19 infection. Conclusion: The experience of this patient serves as a reminder to keep carotid artery dissection on the differential in patients with post-COVID syndrome presenting with headache.; Sender's Comments: Based on the current available information and the plausible drug-event temporal association, a possible contributory role of the suspect product to the development of the reported event Carotid artery dissection cannot be excluded. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate
Medical History/Concurrent Conditions: Anxiety; Celiac disease; Chest pressure (1-month following her COVID-19); COVID-19; Dyspnea; Fatigue (1-month following her COVID-19); GERD; Headache (1-month following her COVID-19); Headache; Shortness of breath (1-month following her COVID-19)
Test Name: CT angiography; Result Unstructured Data: Test Result:confirmed the diagnosis.; Test Name: CT pulmonary angiography; Result Unstructured Data: Test Result:normal; Test Name: serum electrolytes; Result Unstructured Data: Test Result:normal; Test Name: thyroid stimulating hormone; Result Unstructured Data: Test Result:normal; Test Name: chest x-ray; Result Unstructured Data: Test Result:normal; Test Name: computed tomography (CT) of the chest; Result Unstructured Data: Test Result:normal; Test Name: CT head; Result Unstructured Data: Test Result:normal; Test Name: electrocardiogram; Result Unstructured Data: Test Result:normal; Test Name: liver enzymes; Result Unstructured Data: Test Result:normal; Test Name: D-dimer; Result Unstructured Data: Test Result:normal; Test Name: complete blood count; Result Unstructured Data: Test Result:normal; Test Name: Labs; Result Unstructured Data: Test Result:unremarkable except mild neutrophilia; Test Name: magnetic resonance imaging; Result Unstructured Data: Test Result:left internal carotid; Comments: artery dissection; Test Name: neurologic exam; Result Unstructured Data: Test Result:normal; Test Name: Pulmonary function test; Result Unstructured Data: Test Result:mild obstruction