Use of thrombolytic therapy in cerebral venous sinus thrombosis with ulcerative colitis

Kothur, Kavitha; Kaul, Subhash; Rammurthi, S; Bandaru, V C S Srinivasarao; Suryaprabha, Suvarna Alladi T; Mrudula, K Rukmini

doi:10.4103/0972-2327.93276

Cited by 7 publications

(2 citation statements)

References 6 publications

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“…The first-line treatment for CVT is adjusted-dose unfractionated heparin or low-molecular-weight heparin, but its risks should be carefully weighed in light of possible hemorrhagic complications [ 12 ]. Endovascular thrombolysis was tried in a few cases, with favorable and safe outcomes [ 13 ]. This limited evidence supports the use of approved guidelines for cerebral venous thrombosis management [ 12 , 14 ] also when associated with IBD.…”

Section: Discussionmentioning

confidence: 99%

Cerebral venous thrombosis revealing an ulcerative colitis

Taous¹,

Berri²,

Lamsiah³

et al. 2016

Pan Afr Med J

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Cerebral venous thrombosis (CVT) has been reported as an uncommon and devastating complication of ulcerative colitis (UC), with an annual incidence varying between 0,5 to 6,7%. It is suspected to be a consequence of the hypercoagulable state occurring during disease relapse. We report a case of 22-year-old female patient presenting with CVT revealing an UC. Our case raises the awareness among health professionals about the inflammatory bowel diseases (IBD) as a rare etiology of CVT, and signifies the importance of considering antithrombotic prophylaxis in all hospitalised IBD patients, especially those with active disease.

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Section: Discussionmentioning

confidence: 99%

Cerebral venous thrombosis revealing an ulcerative colitis

Taous¹,

Berri²,

Lamsiah³

et al. 2016

Pan Afr Med J

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“…Li G et al, 2013 underwent urokinase 100 to 1500 × 10 IU intravenous sinus injection via a jugular catheter [41]. In Kothur K, case thrombolysis was performed by bolus 100,000 units urokinase injection followed by continuous 70,000 units/hour urokinase infusion [42] .In Guo XB et al [43] 2012, series A microcatheter was put in the superior sagittal sinus or straight sinus and thrombolysis was performed with continuous urokinase (42,000 U/h, total 1,000,000 U/day) infusion. In Xia ZK, series the initial dose of urokinase was 2000 -4000 U/kg/24 hour: the bolus dose was 20 000 -40 000 U (given in 15 -30 minutes), and the remainder was infused through the first day.…”

Section: Urokinase Dosementioning

confidence: 99%

Cerebral venous sinus thrombosis

Yadollahikhales,

Borhani-Haghighi,

Safari

et al. 2016

GMJ

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Cerebral venous thrombosis (CVT) is occlusion of dural sinuses and/or cortical veins due to clot formation. It is a potentiallyÂ Â life-threatening condition that requires rapid diagnosis and urgent treatment. Cerebral venous thrombosis is Â Â more common inÂ Â females and young people. Pregnancy, postpartum state, contraceptive pills,Â infection, malignancy, Â hyper-coagulable state, rheumatological disorders, trauma are among the major etiologies of cerebral venous thrombosis. Headache, focal neurologic deficits and seizure were the most common clinical presentations. Different techniques of unenhanced and contrast enhanced Â Â brainÂ computerized tomography(CT scan)Â and ,magnetic resonance imaging(MRI) are the most helpful ancillary investigations for diagnosis of Cerebral venous thrombosis. Specific treatment Â of the underlying cause of cerebral venous thrombosis should be considered as the mainstay of the treatment. Anticoagulation with heparin or low molecular weight heparinoidsÂ is Â the most accepted treatment. In acute phase, medical Â Â or surgical management to decrease intracranial pressure (ICP) is Â Â also recommended. If the patient's clinicalÂ Â condition aggravates despite adequate anticoagulation, thrombolysis Â or mechanical thrombectomy can be an additive option.

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Cerebral venous thrombosis as presenting manifestation of inflammatory bowel disease (IBD)

et al. 2019

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Background: Venous thrombosis is an important complication in patients with inflammatory bowel disease (IBD) and has multifactorial origin mainly related to haemostatic changes in the presence of active inflammation. In addition, number of coagulation abnormalities may co-exist in active IBD many of which return to normal once inflammatory process is controlled. Cerebral venous thrombosis (CVT) is a very rare but potentially serious extra-intestinal feature in IBD Aim: To describe 2 cases of CVT associated with IBD and review the literature. Materials and methods:Records of 2 patients presenting to our unit with CVT and diagnosed to have IBD were reviewed. The clinical, laboratory, endoscopic and imaging data reviewed. We did a comprehensive literature Pubmed search using the search terms inflammatory bowel disease, colitis and venous thrombosis. Results:We report 2 cases with CVT from UC as a presenting manifestation. Both patients required biologics to control the severe colitis and one had some residual deficits in neurological function. In both patients, cerebral imaging improved on follow up Conclusions: Due to the rarity and variability in presentation, CVT as a presenting manifestation of IBD may be overlooked in emergency departments. Prompt diagnosis, initiation of anticoagulation and control of the pro-coagulant state with treatment of colitis can lead to optimal recovery.

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Use of thrombolytic therapy in cerebral venous sinus thrombosis with ulcerative colitis

Cited by 7 publications

References 6 publications

Cerebral venous thrombosis revealing an ulcerative colitis

Cerebral venous thrombosis revealing an ulcerative colitis

Cerebral venous sinus thrombosis

Cerebral venous thrombosis as presenting manifestation of inflammatory bowel disease (IBD)

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