Cerebral venous thrombosis in inflammatory bowel disease.
Cerebral venous thrombosis (CVT) is a rare but devastating complication of inflammatory bowel disease (IBD). Here we describe six IBD patients with cerebral venous thrombosis. The patients presented with hours to days of headache and were found to have venous thrombosis on imaging. Four of the six patients had ulcerative colitis and two had Crohn's disease. All six patients were treated with therapeutic anticoagulation. There were two deaths; one patient became comatose and died despite anticoagulation while the other recovered well from the sinus thrombosis but died after a bowel perforation 3 weeks later. This case series demonstrates the critical need for early recognition of neurological symptoms in patients with IBD during disease flares. It is important to recognize the clinical signs in order to start anticoagulation expeditiously and improve neurological outcomes.
Department of Gastroenterology and Hepatology, Weill Cornell Medical College/New York Presbyterian Hospital, New York, NY, USA.
Ersilia M
EM
DeFilippis
Elaine
E
Barfield
Dana
D
Leifer
Adam
A
Steinlauf
Brian P
BP
Bosworth
Ellen J
EJ
Scherl
Robbyn
R
Sockolow
D000293:Adolescent; D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D002550:Cerebral Veins; D002648:Child; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications*; D020767:Intracranial Thrombosis / Q000188:drug therapy / Q000209:etiology*; D008297:Male; D012189:Retrospective Studies; D055815:Young Adult
D000925:Anticoagulants
anticoagulation; inflammatory bowel disease; intracranial thrombosis