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From the 9/17/2021 release of VAERS data:

This is VAERS ID 1133212



Case Details

VAERS ID: 1133212 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-03-08
Onset:2021-03-17
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Cerebral haematoma, Cerebral venous sinus thrombosis, Computerised tomogram head abnormal, Headache
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, venous (narrow), Central nervous system vascular disorders, not specified as haemorrhagic or ischaemic (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Amoxicillin
Diagnostic Lab Data: CT head without contrast (3/25/2021): Parenchymal hemorrhage and persistent hyperdensity in the left transverse sinus, consistent with known venous sinus thrombosis.
CDC Split Type:

Write-up: The patient was experiencing headaches 1 week ago. She also had aphasia later in the week. She went to an outside hospital on 3/24/2021 and was found to have intraparenchymal hemorrhage in addition to venous sinus thrombosis. She is being treated for the venous sinus thrombosis with heparin.


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