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From the 7/23/2021 release of VAERS data:

This is VAERS ID 1316875

Case Details

VAERS ID: 1316875 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Wisconsin  
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Private       Purchased by: ?
Symptoms: Angiogram cerebral normal, Aphasia, Arteriogram carotid normal, Cerebral infarction, Cerebral small vessel ischaemic disease, Cerebrovascular accident, Chest pain, Computerised tomogram head normal, Echocardiogram normal, Headache, Hemiparesis, Hypoaesthesia, Magnetic resonance imaging head abnormal, Muscular weakness, Musculoskeletal discomfort, Paraesthesia, Vitamin D deficiency
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (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, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: cholecalciferol 75 mcg Oral Daily ? insulin lispro 20 Units Subcutaneous TID AC ? insulin glargine 36 Units Subcutaneous 2 times per day ? rivaroxaban 20 mg Oral Daily with breakfast atorvastatin 80 mg Oral Nightly ? famotidine 20 m
Current Illness: Has been on blood thinners for acute PE 3 months prior Patient was having a left SI injection on 5/11 and "Per NP from pre-op, the pt received the injection without issue. After the injection she was developed groin numbness, which progressed into a headache, and chest pain. She then became aphasic, with left sided weakness and numbness- brought to ED for eval"
Preexisting Conditions: PMHx of atrerial ischemic stroke, DM2, HTN, HLD, PE, RAD, scoliosis
Allergies: Bee sting Losartan Meloxicam Topamax Codeine
Diagnostic Lab Data: TTE, 5/12/2021: Normal left ventricular size, systolic function and wall thickness, with no regional wall motion abnormalities.Normal diastolic filling pattern. No major valvular abnormalities Agitated saline was injected through a peripheral vein and did not show evidence of a shunt. 05/11/21 MRI Brain WO Contrast Narrative MRI BRAIN WO CONTRAST... Impression IMPRESSION: No acute intracranial abnormality, specifically no acute ischemia. Microangiopathic changes of aging. Small chronic infarcts in the left cerebellar hemisphe 05/11/21 CT Angio Head and Neck Level 1 Narrative CT ANGIOGRAM HEAD AND NECK W CONTRAST LEVEL 1... Impression IMPRESSION: 1. CTA neck: No evidence of significant extracranial vascular stenosis or occlusion. 2. CTA head: No evidence of hemodynamically significant intracranial stenosis, aneurysm, or vascular malformation 05/11/21 CT Head Level 1 Narrative CT HEAD LEVEL 1 - LEVEL 1... Impression IMPRESSION: No acute intracranial abnormality.
CDC Split Type:

Write-up: ED Note: "presents to the ED via RRT from pre-op after having a left SI injection with complaints of a stroke alert. at 1132 this morning. Per NP from pre-op, the pt received the injection without issue. After the injection she was developed groin numbness, which progressed into a headache, and chest pain. She then became aphasic, with left sided weakness and numbness. BS was 154 at that time. Per husband at bedside, the pt had numbness and tingling after injection but was otherwise at baseline. While the pt was getting dressed, the husband went to get the car. He notes the pt is on Xarelto secondary to PE and has taken it as prescribed. He denies any missed doses but states he is unsure of what time the last dose was. He states that the pt has no lasting deficits from her prior stroke. Of note, the pt is able to respond by nodding yes or no but is unable to speak. Pt able to write on a white board. She states she was taken off the Xarelto 3 months ago. The pt states she is unable to talk. She endorses left arm and leg weakness. The pt states she has a prior stoke years ago with weakness but has no lasting deficits. " Admitted to the hospital Diagnoses: -Dysphasia -Small vessel cerebrovascular disease -Bereavement -Vitamin-D deficiency

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