Isolated cerebral thrombo-embolism and Crohn disease

Gormally, Siobhan; Bourke, W.; Kierse, Barry; Monaghan, Hugh; McMenamin, Joe; Drumm, Brendan

doi:10.1007/bf01959788

Cited by 13 publications

(6 citation statements)

References 22 publications

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“…Our finding of an increased risk of ischemic stroke in rather young patients with CD is in accordance with several case reports and case series of cerebrovascular accidents in CD patients <50 years of age 2, 6–9, 12, 17–20. However, reporting bias cannot be ruled out, i.e., the fact that the occurrence of stroke gains particular attention in young patients and is therefore more often reported in patients of this age group.…”

Section: Discussionsupporting

confidence: 92%

Risk of ischemic stroke in patients with Crohnʼs disease

Andersohn

Waring²,

Garbe

2010

Inflammatory Bowel Diseases

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Section: Discussionsupporting

confidence: 92%

Risk of ischemic stroke in patients with Crohnʼs disease

Andersohn

Waring²,

Garbe

2010

Inflammatory Bowel Diseases

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“…42 Most authors described resolution of the thrombosis with systemic anticoagulant therapy. 45 Arterial Thromboembolism Arterial thromboembolic events occur much less frequently than venous thromboembolic complications in IBD, and they may affect the cerebral, [58][59][60][61][62] retinal, [32][33][34] coronary, 10,63 carotid, 64 splanchnic, iliac, renal, upper and lower limb arteries, or the aorta. 8,45,65 The most commonly reported complications associated with arterial thrombosis are ischemia or infarction of the small bowel and colon, and ischemia/ infarction of the leg, foot, and toe.…”

Section: Venous Thromboembolismmentioning

confidence: 99%

Thromboembolism in Inflammatory Bowel Disease: An Insidious Association Requiring a High Degree of Vigilance

Fabio¹,

Lykoudis²,

Gordon³

2011

Semin Thromb Hemost

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Venous and arterial thromboembolism are both serious extraintestinal manifestations of inflammatory bowel disease (IBD). Acquired risk factors seem to play a more prominent role than congenital in promoting thrombotic events. Prevention of thromboembolism is thus mainly aimed at minimizing the acquired/reversible risk factors (e.g., inflammation, immobility, hospitalization, steroid therapy, central intravenous catheters, smoking, oral contraceptives, and deficiency of B vitamins and folate). The diagnosis of venous and arterial thromboembolism is extremely challenging and requires a high degree of vigilance. Deep vein thrombosis and pulmonary embolism may be clinically silent or manifest with only few specific symptoms. Thrombosis of the portal vein system may occur with nonspecific symptoms such as abdominal pain, nausea/vomiting, abdominal tenderness, ascites, and fever. The diagnosis of arterial thromboembolism may also be challenging, particularly when the splanchnic region is involved. Indeed, arterial thrombosis of the splanchnic region tends to be overlooked and misinterpreted as a clinical exacerbation of IBD. Early diagnosis plays a central role in optimizing the therapeutic intervention and reducing the risk of short-term and long-term thrombosis-associated complications. The decision regarding the duration of systemic anticoagulation must take into account the individual risk of intestinal bleeding.

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“…Only articles published in English were included in this review. Information related to the case reports on patients with PIBD complicated by CVE is summarized in Tables 1 [ 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 ] and 2 [ 2 4 19 29 42 43 44 45 46 47 48 49 ].…”

Section: Methodsmentioning

confidence: 99%

Cerebrovascular Events in Pediatric Inflammatory Bowel Disease: A Review of Published Cases

Rohani

Taraghikhah

Nasehi

et al. 2022

Pediatr Gastroenterol Hepatol Nutr

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Pediatric inflammatory bowel disease (PIBD) is a multisystem disorder characterized by intestinal and extraintestinal manifestations and complications. Cerebrovascular events (CVE) are rare extraintestinal complications in patients with PIBD. Statistics show that 3.3% patients with PIBD and 1.3–6.4% adult patients with inflammatory bowel disease (IBD) experience CVE during the course of the disease. Therefore, this study aimed to review the records of children with IBD who developed CVE during the course of the disease. We retrospectively reviewed 62 cases of PIBD complicated by CVE. The mean patient age at the time of thrombotic events was 12.48±4.13 years. The incidence of ulcerative colitis was significantly higher than that of Crohn’s disease (43 [70.5%] vs. 13 [21.3%] patients). Most patients (87.93%) were in the active phase of IBD at the time of CVE. The mean time interval between the onset of IBD and CVE was 20.84 weeks. Overall, 11 (26.83%) patients showed neurological symptoms of CVE at disease onset. The most frequent symptom on admission was persistent and severe headaches (67.85%). The most common site of cerebral venous thrombosis was the transverse sinuses (n=23, 53.48%). The right middle cerebral artery (n=3, 33.34%) was the predominant site of cerebral arterial infarction. Overall, 41 (69.49%) patients who were mostly administered unfractionated heparin or low-molecular-weight heparin (56.09%) recovered completely. Patients with IBD are at a risk of thromboembolism. CVE may be the most common type of thromboembolism. Based on these findings, the most common risk factor for CVE is IBD flares. In patients with CVE, anticoagulant therapy with heparin, followed by warfarin, is necessary.

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Isolated cerebral thrombo-embolism and Crohn disease

Cited by 13 publications

References 22 publications

Risk of ischemic stroke in patients with Crohnʼs disease

Risk of ischemic stroke in patients with Crohnʼs disease

Thromboembolism in Inflammatory Bowel Disease: An Insidious Association Requiring a High Degree of Vigilance

Cerebrovascular Events in Pediatric Inflammatory Bowel Disease: A Review of Published Cases

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