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Cerebral Venous Sinus Thrombosis in Inflammatory Bowel Disease: A Review of Published Case Reports
Aishah Ibrahim Albakr1, Noor AlMohish1
1Department of Neurology, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
Insights
Cerebral venous sinus thrombosis (CVST) is a rare complication in inflammatory bowel disease (IBD). Early diagnosis and management are crucial for better outcomes in IBD patients with CVST.
Area of Science:
- Gastroenterology
- Neurology
- Thrombotic Disorders
Background:
- Cerebral venous sinus thrombosis (CVST) is an uncommon but serious extraintestinal manifestation of inflammatory bowel disease (IBD).
- Delayed diagnosis of CVST in IBD patients is associated with a high risk of adverse clinical outcomes.
- Understanding the interplay between IBD and CVST is critical for effective patient management.
Observation:
- A review of 35 cases identified CVST as a complication in patients with IBD between 2013 and 2020.
- CVST was more prevalent in ulcerative colitis than Crohn's disease, with active IBD noted in 91.4% of cases.
- Headache was the most common symptom (85.7%), and corticosteroid use was a frequent prothrombotic risk factor (57.14%).
Findings:
- The mean age of affected patients was 24.6 years, with a male predominance.
- The average time from IBD diagnosis to CVST onset was 3 years.
- The overall recovery rate was 77.14%, with a 10% bleeding complication rate.
Implications:
- This review underscores the importance of recognizing CVST in IBD patients for earlier diagnosis and intervention.
- Preventive strategies for CVST in IBD should be considered, especially in patients on corticosteroid therapy.
- A multidisciplinary approach is essential for managing the complexities of concurrent IBD and CVST.
Abstract:
Cerebral venous sinus thrombosis (CVST) is a rare extraintestinal manifestation of inflammatory bowel disease (IBD), and the risk of poor clinical outcomes remains high in patients with delayed CVST diagnoses. This study aimed to highlight the need to recognize the critical nature of CVST complications in IBD and the challenges associated with managing concurrent conditions. We retrospectively reviewed previously reported cases of CVST in patients with IBD by searching the PubMed, Web of Science, and Google Scholar databases for articles published between 2013 and 2020. Our search identified 35 cases of IBD complicated by CVST. The mean patient age was 24.6 years (range, 31 months-47 years; men > women, ratio, 1.18:1). CVST was 3.8 times more common among patients with ulcerative colitis than among those with Crohn's disease. Active IBD was reported in 91.4% of patients. The mean interval between IBD diagnosis and CVST occurrence was 3 years (range, 2 days-16 years). Headache was the most frequently reported symptom (85.7%), and involvement of multiple sinuses was reported in almost two-thirds of the patients. Corticosteroid therapy at the time of the CVST event was the most common prothrombotic risk factor, present in 57.14% of patients. The overall recovery rate after treatment was 77.14%; whereas the bleeding complication rate was 10%. This review provides essential information that can aid clinicians in making earlier diagnoses and promotes preventive strategies for CVST in patients with IBD. Given that CVST management can be challenging in these patients, a multidisciplinary approach is warranted.
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