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Cerebral venous thrombosis in a child with inflammatory bowel disease
BACKGROUND: Inflammatory bowel disease (IBD) has both intestinal and extraintestinal manifestations. Inflammatory bowel disease is a known risk factor for cerebral venous thrombosis (CVT) in adults and children. The precise mechanism of the thrombotic event is unclear in IBD patients. We report a ca...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Shahid Beheshti University of Medical Sciences
2021
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8272551/ https://www.ncbi.nlm.nih.gov/pubmed/34282373 http://dx.doi.org/10.22037/ijcn.v15i3.32771 |
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author | ROHANI, Pejman JAVADZADEH, Mohsen KHALILI, Mitra ZOJAJI, Reyhaneh |
author_facet | ROHANI, Pejman JAVADZADEH, Mohsen KHALILI, Mitra ZOJAJI, Reyhaneh |
author_sort | ROHANI, Pejman |
collection | PubMed |
description | BACKGROUND: Inflammatory bowel disease (IBD) has both intestinal and extraintestinal manifestations. Inflammatory bowel disease is a known risk factor for cerebral venous thrombosis (CVT) in adults and children. The precise mechanism of the thrombotic event is unclear in IBD patients. We report a case of ulcerative colitis with CVT admitted for acute relapse. CASE PRESENTATION: A 12-year-old boy, who was a known case of ulcerative colitis since 12 months ago, was admitted to our hospital because of bloody diarrhea and recurrent colicky abdominal pain. On the third day of admission, the patient complained of severe headache. The level of consciousness decreased gradually during 12 hours and became aphasic later. One episode of tonic-clonic seizure happened 18 hours after the onset of headache. Neurologic examination showed right hemiparesis. Physical examinations, including blood pressure and fundoscopy were unremarkable on the last admission. Brain computed tomography (CT) showed intraparenchymal hemorrhage in the left temporal lobe with asymmetric increased density in the left lateral sinus. The magnetic resonance imaging (MRI) results revealed abnormal hyperintense signal in the left lateral sinus in T1WI and T2WI, which is compatible with thrombosis (loss of signal) in magnetic resonance venography (MRV). Low-molecular-weight heparin was administered according to consultation with a hematologist and continued post-discharge. The patient’s condition improved slowly, and neurologic evaluation was normal after three months. CONCLUSION: Cerebrovascular events, such as cerebral venous thrombosis (CVT) or cerebral arterial infarction (CAI), are rare extraintestinal manifestations of PIBD but probably the most common forms of thromboembolism in children. Probably, treatment of CVT with anticoagulants is the best way of management. A comprehensive study is essential to understand the choice, efficacy, duration, and primary and secondary prophylaxis protocol with anticoagulants. |
format | Online Article Text |
id | pubmed-8272551 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Shahid Beheshti University of Medical Sciences |
record_format | MEDLINE/PubMed |
spelling | pubmed-82725512021-10-01 Cerebral venous thrombosis in a child with inflammatory bowel disease ROHANI, Pejman JAVADZADEH, Mohsen KHALILI, Mitra ZOJAJI, Reyhaneh Iran J Child Neurol Case Report BACKGROUND: Inflammatory bowel disease (IBD) has both intestinal and extraintestinal manifestations. Inflammatory bowel disease is a known risk factor for cerebral venous thrombosis (CVT) in adults and children. The precise mechanism of the thrombotic event is unclear in IBD patients. We report a case of ulcerative colitis with CVT admitted for acute relapse. CASE PRESENTATION: A 12-year-old boy, who was a known case of ulcerative colitis since 12 months ago, was admitted to our hospital because of bloody diarrhea and recurrent colicky abdominal pain. On the third day of admission, the patient complained of severe headache. The level of consciousness decreased gradually during 12 hours and became aphasic later. One episode of tonic-clonic seizure happened 18 hours after the onset of headache. Neurologic examination showed right hemiparesis. Physical examinations, including blood pressure and fundoscopy were unremarkable on the last admission. Brain computed tomography (CT) showed intraparenchymal hemorrhage in the left temporal lobe with asymmetric increased density in the left lateral sinus. The magnetic resonance imaging (MRI) results revealed abnormal hyperintense signal in the left lateral sinus in T1WI and T2WI, which is compatible with thrombosis (loss of signal) in magnetic resonance venography (MRV). Low-molecular-weight heparin was administered according to consultation with a hematologist and continued post-discharge. The patient’s condition improved slowly, and neurologic evaluation was normal after three months. CONCLUSION: Cerebrovascular events, such as cerebral venous thrombosis (CVT) or cerebral arterial infarction (CAI), are rare extraintestinal manifestations of PIBD but probably the most common forms of thromboembolism in children. Probably, treatment of CVT with anticoagulants is the best way of management. A comprehensive study is essential to understand the choice, efficacy, duration, and primary and secondary prophylaxis protocol with anticoagulants. Shahid Beheshti University of Medical Sciences 2021 /pmc/articles/PMC8272551/ /pubmed/34282373 http://dx.doi.org/10.22037/ijcn.v15i3.32771 Text en https://creativecommons.org/licenses/by/3.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License, (http://creativecommons.org/licenses/by/3.0/ (https://creativecommons.org/licenses/by/3.0/) ) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Case Report ROHANI, Pejman JAVADZADEH, Mohsen KHALILI, Mitra ZOJAJI, Reyhaneh Cerebral venous thrombosis in a child with inflammatory bowel disease |
title | Cerebral venous thrombosis in a child with inflammatory bowel disease |
title_full | Cerebral venous thrombosis in a child with inflammatory bowel disease |
title_fullStr | Cerebral venous thrombosis in a child with inflammatory bowel disease |
title_full_unstemmed | Cerebral venous thrombosis in a child with inflammatory bowel disease |
title_short | Cerebral venous thrombosis in a child with inflammatory bowel disease |
title_sort | cerebral venous thrombosis in a child with inflammatory bowel disease |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8272551/ https://www.ncbi.nlm.nih.gov/pubmed/34282373 http://dx.doi.org/10.22037/ijcn.v15i3.32771 |
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