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Updated: Jun 19, 2026
A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia
Published on: August 18, 2015
Cerebral thromboembolic events in pediatric patients with inflammatory bowel disease
A R Barclay1, J M Keightley, I Horrocks
1Division of Developmental Medicine, University of Glasgow, Glasgow, UK. A.Barclay@clinmed.gla.ac.uk
Insights
Cerebral thromboembolic events (CTEs) affect pediatric inflammatory bowel disease (IBD) patients, with a rising trend observed in Crohn's disease (CD) cases. Early identification and management of risk factors are crucial for primary prevention.
Area of Science:
- Pediatric Neurology
- Gastroenterology
- Thrombotic Disorders
Background:
- A known association exists between pediatric inflammatory bowel disease (IBD) and cerebral thromboembolic events (CTEs).
- Historically, ulcerative colitis (UC) was thought to have a stronger association with CTEs than Crohn's disease (CD).
Observation:
- This study analyzed 154 new pediatric IBD cases over 5 years, identifying 4 instances of CTE (2.6%).
- All pediatric IBD patients with CTE had identifiable risk factors.
- A literature review revealed a significant increase in reported strokes in CD patients after January 2000.
Findings:
- Cerebral thromboembolic events (CTEs) occur in a notable proportion of pediatric inflammatory bowel disease (IBD) patients.
- While physical impairment often resolves, significant morbidity associated with CTEs in pediatric IBD is evident.
- A secular trend suggests an increasing incidence of CTEs in pediatric Crohn's disease (CD).
Implications:
- The findings highlight the importance of recognizing CTEs as a complication in pediatric IBD.
- Primary prevention strategies focusing on identifying and mitigating risk factors are essential for managing CTEs in this population.
- Further research should investigate the underlying mechanisms and optimal preventive measures for CTEs in pediatric IBD, particularly in CD.
Background:
There is a recognized association between pediatric inflammatory bowel disease (IBD) and cerebral thromboembolic events (CTEs). Historical reporting had described the association as strongest between ulcerative colitis (UC), rather than Crohn's disease (CD). We describe the incidence and outcome of CTE in pediatric IBD patients from a single center over 5 years and the relative proportion of stroke reported in the literature in patients with UC and CD before and after January 2000.
Methods:
Demographic data were extracted on all newly diagnosed cases of IBD in our center from January 2003 to January 2008 to ascertain patient characteristics, disease type, risk factors for CTE, modality of neuroimaging, and outcome. A literature search was performed to identify all articles describing stroke in pediatric IBD. All identified studies were stratified into those published before and after January 1 2000.
Results:
In all, 154 new patients diagnosed with IBD (male 56%) (UC 30%, CD 64%, IBD unclassified [IBDU] 6%) were reviewed. Four cases of CTE occurred in our population over 5 years (2.6%). All patients had a risk factor for CTE. Fifteen case series were identified with 32 patients. There was a significant increase in the proportion strokes affecting patients with CD reported after January 2000 (P = 0.02).
Conclusions:
CTE affects a proportion of pediatric IBD patients. Although resolution of physical impairment is the norm, significant morbidity exists. Our study suggests a secular trend toward CTE in CD. Primary prevention with the identification and amelioration of identifiable risk factors should be the clinical objective in future studies.
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