Cerebral venous thrombosis in inflammatory bowel disease: a case series

Samia, Ben Sassi; Kallel, Lamia; Nabli, Fatma; Sawssen, Ben Romdhane; Ellouze, R.; Zouari, M.; Neila, Ben Romdhane; Filali, Azza; Hentati, Fayçal

doi:10.1007/s00384-010-0973-y

Cited by 6 publications

(6 citation statements)

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“…The management of CVST in patients with IBD should focus on controlling the inflammation and dissolving the thrombus. Certain mediations used for IBD also inhibit platelet activation, such as 5-aminosalicylic acid, azathioprine, 6-mercaptopurine, and infliximab, while steroids used in the active phase of ulcerative colitis also reduce intracerebral edema [15]. To dissolve the thrombus and prevent propagation, however, lowmolecular-weight heparin should be used for anticoagulation [16].…”

Section: Discussionmentioning

confidence: 99%

Cerebral Venous Sinus Thrombosis is a Reversible Complication of Ulcerative Colitis

Ghadeer¹,

Alsalman²,

Alobaid³

et al. 2022

Cureus

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Patients with inflammatory bowel disease (IBD) are at higher risk of venous thrombosis than the general population, with thromboembolism being a recognized extraintestinal manifestation. Although thrombotic events typically present as deep vein thrombosis and pulmonary embolism, other presentations are possible. Cerebral venous sinus thrombosis (CVST) is a relatively rare example associated with high morbidity and a mortality rate of 50% when misdiagnosed or the diagnosis is delayed. Despite this, CVST is a reversible complication with favorable outcomes when diagnosed early and treated appropriately. In this report, we present a case of cerebral sinus thrombosis in a 35-year-old female during a relapse of ulcerative colitis. During the relapse of ulcerative colitis, CVST manifested with a seizure, focal neurological deficit, and altered mental status. After blood workup, magnetic resonance imaging (MRI), and venography, the diagnosis of CVST was confirmed. We immediately started the patient on low-molecular-weight heparin, and during a six-month follow-up period, she made a full recovery with recanalization of the thrombosis on imaging. Despite CVST being a fatal complication of IBD, our report and data in the literature indicate that full remission is possible when it is correctly diagnosed and treated.

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Section: Discussionmentioning

confidence: 99%

Cerebral Venous Sinus Thrombosis is a Reversible Complication of Ulcerative Colitis

Ghadeer¹,

Alsalman²,

Alobaid³

et al. 2022

Cureus

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“…Currently, there are no established guidelines for the management of CVT in IBD . However, the American Heart Association and American Stroke Association suggest that a clinical suspicion of CVT should prompt evaluation with MRI and MRV .…”

Section: Discussionmentioning

confidence: 99%

“…The risk of arterial and venous thrombotic events is increasing in both adult and pediatric patients with inflammatory bowel disease (IBD) . Cerebral venous thrombosis (CVT) is a rare but devastating complication of IBD that is estimated to occur in 0.5–7.5% of patients . CVT is thought to be secondary to increased platelet activation, the activation of the coagulation cascade, impaired fibrinolysis and transient coagulation abnormalities .…”

Section: Introductionmentioning

confidence: 99%

“…Endothelial dysfunction in the regulation of inflammation, coagulation and vascular repair may also play a role in the pathogenesis of IBD . Thrombosis appears to be more common in ulcerative colitis (UC), but there remains an increased risk in those with Crohn's disease (CD) . Patients with IBD‐related CVT tend to be younger with a male predominance .…”

Section: Introductionmentioning

confidence: 99%

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Cerebral venous thrombosis in inflammatory bowel disease

DeFilippis

Barfield

Leifer

et al. 2015

J of Digest Diseases

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Cerebral venous thrombosis (CVT) is a rare but devastating complication of inflammatory bowel disease (IBD). Here we describe six IBD patients with cerebral venous thrombosis. The patients presented with hours to days of headache and were found to have venous thrombosis on imaging. Four of the six patients had ulcerative colitis and two had Crohn's disease. All six patients were treated with therapeutic anticoagulation. There were two deaths; one patient became comatose and died despite anticoagulation while the other recovered well from the sinus thrombosis but died after a bowel perforation 3 weeks later. This case series demonstrates the critical need for early recognition of neurological symptoms in patients with IBD during disease flares. It is important to recognize the clinical signs in order to start anticoagulation expeditiously and improve neurological outcomes.

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“…Furthermore, endothelial dysfunction and a reduction of fibrinolytic activity may also increase the risk of thrombosis in these patients. 83,84 Given the number of case reports and case series, [85][86][87] the risk of CVT is probably also increased in patients with IBD, although, similar to previously mentioned risk factors, controlled studies are not available. Overall, IBD is reported in 2% of patients with CVT.…”

Section: Inflammatory Bowel Diseasementioning

confidence: 99%

Risk Factors for Cerebral Venous Thrombosis

Silvis

Middeldorp

Zuurbier

et al. 2016

Semin Thromb Hemost

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Cerebral venous thrombosis (CVT) is a rare thrombotic disorder involving the cerebral veins and dural sinuses. In contrast to more common sites of venous thromboembolism (VTE), such as the legs and lungs, CVT mainly affects young adults and children, and women are affected three times more often than men. Although presenting symptoms are variable, headache is usually the first symptom, often in combination with focal neurologic deficits and epileptic seizures. The primary therapy for CVT consists of heparin followed by oral anticoagulation for at least 3 to 6 months. The mortality in the acute phase is 5 to 10% and a substantial proportion of survivors suffer from long-term disabilities. A large number of risk factors have been linked to CVT, although the scientific evidence for an association varies considerably between risk factors. Some risk factors, such as hereditary thrombophilia, correspond with risk factors for more common sites of VTE, whereas others, such as head trauma, are specific to CVT. In most patients, at least one risk factor can be identified. In this review, we provide an overview of the risk factors for CVT.

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Cerebral venous thrombosis in inflammatory bowel disease: a case series

Cited by 6 publications

References 0 publications

Cerebral Venous Sinus Thrombosis is a Reversible Complication of Ulcerative Colitis

Cerebral Venous Sinus Thrombosis is a Reversible Complication of Ulcerative Colitis

Cerebral venous thrombosis in inflammatory bowel disease

Risk Factors for Cerebral Venous Thrombosis

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