title: Internal carotid thrombus in patients with inflammatory bowel disease: two cases.
abstract: Increased ischemic stroke risk is observed in patients with inflammatory bowel disease (IBD). Causes and physiopathological aspects of cerebral infarct, in this specific population, are less often described. There is little information to provide guidelines for the best curative and preventive treatment. We report 2 cases of ischemic strokes due to internal carotid thrombus in patients during active phase of IBD. Ulceration of early atherosclerotic plaques activated by a hypercoagulation state may cause a thrombus. A combined therapy with heparin and corticosteroids was used for both our patients. Lysis of the thrombus was obtained after several days without surgical treatment and shown by ultrasonography. These cases highlight an aetiology of stroke in patients with IBD and use of a synergic treatment to respond to hypercoagulability in link with IBD. Benefits and safety of this therapy should be confirmed with clinical studies.
authors: Department of Neurology, CHU Nancy, Hospital Central, 54035 Nancy Cedex, France. s.richard@chu-nancy.fr
authors: Sébastien
authors: S
authors: Richard
authors: Gioia
authors: G
authors: Mione
authors: Julien
authors: J
authors: Perrin
authors: Marie
authors: M
authors: Toussaint-Hacquard
authors: Jean-Christophe
authors: JC
authors: Lacour
authors: Xavier
authors: X
authors: Ducrocq
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D001777:Blood Coagulation; D002545:Brain Ischemia / Q000209:etiology; D002340:Carotid Artery Diseases / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D002341:Carotid Artery Thrombosis / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000378:metabolism; D003093:Colitis, Ulcerative / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D003424:Crohn Disease / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D005260:Female; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D008297:Male; D020521:Stroke / Q000209:etiology; D015912:Thrombolytic Therapy; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography
chemical_list: D000305:Adrenal Cortex Hormones; D000925:Anticoagulants; D006493:Heparin
keywords: Atherosclerosis; Carotid thrombus; Hypercoagulable state; Inflammatory bowel disease; Ischemic stroke