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[Cerebral infarction in Crohn's disease]
Y Bar Dayan1, Y Levi, Y Shoenfeld
1Medical Dept. B, Chaim Sheba Hospital, Tel Hashomer and Sackler School of Medicine, Tel Aviv University.
Harefuah
|September 1, 1995
Summary
Crohn's disease patients face a heightened risk of thromboembolic events, including rare cerebral artery thrombosis. This case highlights the potential for severe neurological complications in Crohn's disease patients.
Area of Science:
- Neurology
- Gastroenterology
- Hematology
Background:
- Crohn's disease is a chronic inflammatory bowel disease.
- Thromboembolic complications are known, though typically involve disseminated vascular thrombosis or pulmonary emboli.
- Cerebral artery thrombosis is an exceptionally rare manifestation.
Observation:
- A 27-year-old female with an 8-year history of Crohn's disease presented with an exacerbation.
- Symptoms included bloody diarrhea, abdominal pain, weight loss, weakness, and severe anemia (hemoglobin 6.3 g/dl).
- Following blood transfusions, she developed generalized tonic-clonic convulsions and hemiparesis.
Findings:
- Neurological examination and neuroimaging (EEG, CT) confirmed a right temporal lobe infarction.
- This indicates a cerebral artery thrombosis as a complication of Crohn's disease.
- The patient's presentation underscores the hypercoagulable state associated with Crohn's disease.
Implications:
- This case emphasizes the critical need to consider thromboembolic events, including stroke, in Crohn's disease patients, especially during exacerbations.
- Early recognition and management of hypercoagulability in Crohn's disease are crucial for preventing potentially fatal complications.
- Further research into the mechanisms of hypercoagulability in Crohn's disease may lead to improved preventative strategies.