title: Cerebrovascular complications in patients with inflammatory bowel disease.
abstract: Cerebrovascular complications in 9 patients with inflammatory bowel disease (IBD) are presented, 6 with Crohn's disease (CD) and 3 with ulcerative colitis (UC), 7 men and 2 women, mean age 36.5 +/- 3.5 years, 4 of them during acute disease. Cerebrovascular complications were: cerebral venous thrombosis (CVT)--7 cases (5 CD and 2 UC) and ischemic stroke--2 cases (1 CD and 1 UC). Out of 7 cases with CVT 5 were superior sagittal sinus thrombosis (SSS), 2 SSS and transverse and sigmoid sinus thrombosis. Both ischemic strokes were infarctions in the middle cerebral artery area. No correlation between high doses of corticosteroids or their lowering, IBD activity, duration of the disease, and the appearance of cerebrovascular complications was observed. Tendency to hypercoagulation even in the inactive stage of the IBD was revealed. Investigations for thrombophilia were negative. Significantly high levels of homocysteine were observed in all patients.
  
  
  CONCLUSIONS
  Neurovascular complications may be observed in IBD, both of venous and arterial type. Pathogenic mechanisms of these vascular complications are complex, low serum folate levels, of vitamin B6 and B12 being associated with elevation of homocysteine levels, high activation of platelets and microvascular endothelial dysfunction. A guide for the orientation of prophylaxis of cerebrovascular complications in IBD patients is necessary.
authors.forename: Inimioara Mihaela
authors.initials: IM
authors.lastname: Cojocaru
authors.forename: M
authors.initials: M
authors.lastname: Cojocaru
authors.forename: Violeta
authors.initials: V
authors.lastname: Sapira
authors.forename: Andreea
authors.initials: A
authors.lastname: Ionescu
authors.forename: Natalia
authors.initials: N
authors.lastname: Tacu
mesh_terms: D000328:Adult; D002544:Cerebral Infarction / Q000175:diagnosis / Q000209:etiology*; D003093:Colitis, Ulcerative / Q000097:blood / Q000150:complications*; D003424:Crohn Disease / Q000097:blood / Q000150:complications*; D005260:Female; D006710:Homocysteine / Q000097:blood; D006801:Humans; D020227:Lateral Sinus Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology; D008279:Magnetic Resonance Imaging; D008297:Male; D020768:Middle Cerebral Artery; D011859:Radiography; D020225:Sagittal Sinus Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology*; D020246:Venous Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology*
chemical_list: D006710:Homocysteine