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This is VAERS ID 275712

Case Details

VAERS ID: 275712 (history)  
Age: 13.0  
Gender: Female  
Location: Florida  
Vaccinated:2007-04-03
Onset:2007-04-03
   Days after vaccination:0
Submitted: 2007-04-06
   Days after onset:3
Entered: 2007-04-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0188U / 0 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U226AA / 0 RA / IM

Administered by: Private       Purchased by: Private
Symptoms: Computerised tomogram abnormal, Fall, Head injury, Headache, Neck pain, Subarachnoid haemorrhage, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Haemorrhagic central nervous system vascular conditions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (broad), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: Allergic to penicillin ALLERGIES: PCN, urticaria. PMH: fainting episodes, mild concussion 3-5 mos ago from sports injury. Pounding headaches 1-3 x/week. Family hx of headaches.
Diagnostic Lab Data: LABS: CT at transfer hospital revealed hemorrhagic focus within medial left frontal high convexity adjacent to falx w/subdural hematoma along the falx. WBC 19.8. CT angiography was WNL. EEG was reported as neg but no report provided.
CDC Split Type:

Write-up: Fainted within 10 min of receiving vaccines and fell backward and hit head on carpeted floor was unresponsive for 20-30 seconds. Complained of headache and neck pain. Transported to ER - CT showed traumatic subarachnoid hemorrhage. Transferred to PICU. 5/11/07 Received medical records from hospital which reveal patient experienced syncopal episode & fell backward w/o bracing herself, striking posterior head & becoming dazed & minimally responsive for several minutes. Seen at outlying hospital & had CT scan which revealed SAH & skull fx. Exam revealed alert & oriented, hematomas over skull. Tx w/dilantin. Neurosurg & neurology consults done. Seizure was ruled out & dilantin d/c. Strong suspicion for vascular abnormality due to amount of intracranial bleeding after fall. FINAL DX: traumatic subarachnoid hematoma.


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