Cerebral Venous Thrombosis Associated with Inflammatory Bowel Diseases: Two Case Reports and Review of The Literature
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Cerebral venous thrombosis, inflammatory bowel disease, ulcerative colitis, Crohn's disease, prethrombotic state, Budd-Chiari syndrome
Abstract
The risk of venous thrombosis is increased during inflammatory bowel diseases (IBD). It has been demonstrated that patients with IBD present a well-defined prethrombotic state with most often a combination of several abnormalities. Cerebral venous thrombosis (CVT) remains exceptional, then we report two cases. The first is that of a 25-year-old woman with a history of ulcerative colitis (UC) since one year, admitted for a severe flare-up accompanied by neurological signs. Magnetic resonance angiography (MRI) revealed CVT. The assessment of thrombophilia showed a deficiency in protein S and C. An anticoagulant treatment allowed a regression of the clinical and radiological manifestations. The severe attack of UC was controlled by AntiTNFα, because of the patient's corticosteroid dependence and intolerance to immunosuppressants. Thereby she remained asymptomatic for three years. The second case describes a 17-year-old patient with a history of right hemicolectomy four years ago due to Crohn's disease (CD) complicated by ileocolic stenosis. Six months later, the patient was admitted for CVT which resolved on anticoagulant, however the thrombosis reappeared a year later in the suprahepatic veins and ileofemoral veins, complicated by portal hypertension syndrome. A protein C deficiency was discovered. Anticoagulant treatment associated with the specific treatment of CD allowed a clinical and biological improvement with a follow-up of two years.
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