Cerebral venous thrombosis in inflammatory bowel disease

DeFilippis, Ersilia M.; Barfield, Elaine; Leifer, Dana; Steinlauf, Adam F.; Bosworth, Brian; Scherl, Ellen

doi:10.1111/1751-2980.12212

Cited by 19 publications

(22 citation statements)

References 30 publications

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“…CVST occurs in 0.5–7.5% of patients with chronic inflammatory bowel diseases, as a complication of the hypercoagulable state due to mucosal inflammation that leads to upregulation of tissue factor, high platelet count and impaired fibrinolysis . Additional systemic conditions are vasculitis, especially Behçet disease, with an incidence rate for CVST of 3 per 1000 p‐y , whereas few data are available on systemic lupus erythematosus and nephrotic syndrome .…”

Section: Risk Factorsmentioning

confidence: 99%

Cerebral venous sinus thrombosis

Capecchi

Abbattista

Martinelli

2018

Journal of Thrombosis and Haemostasis

173

174

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The cerebral venous system is an unusual site of thrombosis, with a particularly high incidence in young adults. This incidence has increased in past decades because of the improvement of neuroradiological techniques. Risk factors for cerebral venous sinus thrombosis overlap with those of other venous thromboembolism sites; however, some are specific for this particular anatomical district. Prognosis is favorable in most cases if diagnosis is made rapidly and treatment is promptly initiated, even if acute complications or chronic invalidity still occur in a quarter of patients. The mainstay of treatment is anticoagulation, which is necessary in order to block clot propagation and obtain recanalization. Intracranial bleeding does not contraindicate anticoagulation. Endovascular procedures are reserved for patients with a particularly severe presentation or rapidly declining neurological symptoms despite appropriate anticoagulation, although data from clinical trials are lacking. Specifically, this review addresses the epidemiology, clinical presentation and course, risk factors, and treatment of cerebral venous sinus thrombosis, with a special focus on the pediatric population.

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Section: Risk Factorsmentioning

confidence: 99%

Cerebral venous sinus thrombosis

Capecchi

Abbattista

Martinelli

2018

Journal of Thrombosis and Haemostasis

173

174

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“…Compared to deep vein thrombosis and pulmonary embolism, cerebral sinus vein thrombosis is a rare condition in IBD, affecting 0.5 -7.5 % of patients at some point in the course of their disease [11]. Importantly, in 90 % of these patients, including the present case, this is the first thromboembolic manifestation [12].…”

Section: Discussionmentioning

confidence: 63%

Traveler's Diarrhea, vision abnormalities and unsteady gait in a young woman

et al. 2017

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We report on the course of disease in a young woman, originally admitted with suspected refractory infectious tropical traveler's diarrhea. However, symptoms did not resolve upon either symptomatic or subsequent antibiotic therapy. When neurologic deterioration was observed, imaging studies revealed a dramatic series of thromboembolic events, including intracranial hemorrhage caused by extensive sinus vein thrombosis as well as thrombi of the right cardiac ventricle. Colonic mucosal biopsy samples finally led to the histologic diagnosis of ulcerative colitis. Having excluded thrombophilia or any other disease potentially related to a prothrombotic state, we interpreted the thromboembolic events as secondary to the primary manifestation of the underlying inflammatory bowel disease.The increased risk of thromboembolic complications-especially deep vein thrombosis and pulmonary embolism-in inflammatory bowel disease is well documented in the literature. However, sinus vein thrombosis and cardiac thrombi represent a remarkable dimension of this risk and a rare course of coagulopathy secondary to an acute flare of ulcerative colitis. Still, there is a lack of awareness of this risk, resulting in poor implementation of preventive measures modifying risk factors and allowing for pharmacological prophylaxis. We therefore emphasize that-in line with the 2014 German S3 Guideline-thromboprophylaxis in the setting of an acute flare of inflammatory bowel disease is mandatory and should not be restricted because of safety concerns.

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“…Stroke and central venous thrombosis (CVT) should also be considered as possibilities in the differential diagnoses for RPLS (9). CVT is a rare but devastating complication for IBD patients who are prone to thrombosis (17)(18)(19). The most common symptom of CVT is headache (80%), followed by seizure (35%), and altered conscious (21%), which are similar to the neurological symptoms of RPLS (18).…”

Section: Discussionmentioning

confidence: 99%

Reversible Posterior Leukoencephalopathy Syndrome Associated with Treatment for Acute Exacerbation of Ulcerative Colitis

et al. 2016

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Reversible posterior leukoencephalopathy syndrome (RPLS) is a clinical syndrome of varying etiologies with similar neuroimaging findings. This is a case report of a 25-year-old woman who developed typical, neurological symptoms and magnetic resonance imaging abnormalities after treatment for the acute exacerbation of ulcerative colitis (UC), which included blood transfusion, the systemic administration of prednisolone, and the administration of metronidazole. It has been reported that these treatments may contribute to the development of RPLS. RPLS should therefore be considered in the differential diagnosis of UC patients who exhibit impaired consciousness, seizures or visual deficits during treatment. We report a rare case of RPLS in a patient with UC.

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Cerebral venous thrombosis in inflammatory bowel disease

Cited by 19 publications

References 30 publications

Cerebral venous sinus thrombosis

Cerebral venous sinus thrombosis

Traveler's Diarrhea, vision abnormalities and unsteady gait in a young woman

Reversible Posterior Leukoencephalopathy Syndrome Associated with Treatment for Acute Exacerbation of Ulcerative Colitis

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