An unusual case of neuro-Behçet’s disease presenting with co-occurence of cerebral venous sinus thrombosis with basilar artery occlusion

Abstract

Non-parenchymal neuro-Behçet disease generally affects cerebral venous sinuses, whereas intracranial intracerebral arterial involvement has been rarely reported. But co-involvement of both intracranial intracerebral artery and venous vascular systems in a patient at the same time has not been mentioned before. To the best of our knowledge, this case involving a 25-year-old male with a 7-year history of Behçet disease is the first reported of this type of involvement. He developed occlusion of the basilar artery together with thrombosis of the left sigmoid sinus, distal internal jugular vein, and straight sinus. He was successfully treated with a combination of high-dose steroid and cyclophosphamide. Cranial magnetic resonance angiography demonstrated the resolution of these abnormalities.

Cerebral Venous Thrombosis in Behçet's Disease Patients Compared to Other Causes of Cerebral Venous Thrombosis: a Retrospective Study

“…[2,9,[11][12][13][14][15][16][17]20,30,[34][35][36][37][38][39][40] Moreover, warfarin and acetyl salicylic acid have been given to some CVT patients with BD. [10][11][12]17,26,34 Wechsler et al 14 reported that treatment of CVT during acute phase consisted of combined heparin and steroids in 19 patients, steroids alone in three, and heparin alone in three others.…”

“…35 Colchium, prednisolone, azathioprine, cyclosporine, and cyclophosphamide have been administered to prevent the recurrence of CVT in BD. 2,9,15,17,[26][27][28]30,[36][37][38][39][40][41][42] Acetazolamide and lumboperitoneal shunts have been installed to reduce intracranial hypertension in some CVT patients with BD. 20,25 We administered colchium, azathioprine, and/or prednisolone to our patients to prevent recurrence and we have not observed any recurrence during follow-up in CVT patients with BD.…”

Thrombosis in Autoimmune Diseases: A Role for Immunosuppressive Treatments?

“…Cyclophosphamide is a milestone in the treatment of autoimmune diseases and several case reports found that it might be useful in the prevention of recurrent thrombotic events in these patients. [154][155][156][157][158]…”

Subarachnoid Hemorrhage, Intraparenchymal Hemorrhage and Cerebral Infarction Have Seen a Case of Had Neurobehçet's Disease

“…İntraserebral hemorajinin nedeninin vasküler yapılardaki inflamasyona bağlı olabileceği öne sürülmektedir. 21 Behçet hastalığında çok nadir de olsa, SAK, intraparankimal hemoraji ve iskeminin aynı hastada ortaya çıkabileceği göz önünde bulundurulmalıdır.…”