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Case Reports
. 2022 Mar 12;14(3):e23099.
doi: 10.7759/cureus.23099. eCollection 2022 Mar.

Cerebral Venous Sinus Thrombosis is a Reversible Complication of Ulcerative Colitis

Affiliations
Case Reports

Cerebral Venous Sinus Thrombosis is a Reversible Complication of Ulcerative Colitis

Hussain A Al Ghadeer et al. Cureus. .

Abstract

Patients with inflammatory bowel disease (IBD) are at higher risk of venous thrombosis than the general population, with thromboembolism being a recognized extraintestinal manifestation. Although thrombotic events typically present as deep vein thrombosis and pulmonary embolism, other presentations are possible. Cerebral venous sinus thrombosis (CVST) is a relatively rare example associated with high morbidity and a mortality rate of 50% when misdiagnosed or the diagnosis is delayed. Despite this, CVST is a reversible complication with favorable outcomes when diagnosed early and treated appropriately. In this report, we present a case of cerebral sinus thrombosis in a 35-year-old female during a relapse of ulcerative colitis. During the relapse of ulcerative colitis, CVST manifested with a seizure, focal neurological deficit, and altered mental status. After blood workup, magnetic resonance imaging (MRI), and venography, the diagnosis of CVST was confirmed. We immediately started the patient on low-molecular-weight heparin, and during a six-month follow-up period, she made a full recovery with recanalization of the thrombosis on imaging. Despite CVST being a fatal complication of IBD, our report and data in the literature indicate that full remission is possible when it is correctly diagnosed and treated.

Keywords: alahsa; cerebral venous sinus thrombosis; extraintestinal; inflammatory bowel disease; saudi arabia; thromboembolism; ulcerative colitis.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. NECT axial (A,B) and coronal reformatted (C) show cortical and subcortical hypodensity with hyperdense foci (petechial hemorrhage) involving frontal, temporal, and insula on right side. Hyperdense cortical vein (red arrow).
Figure 2
Figure 2. Axial T2WI (A) and DWI (B) in the same patient show hyperintensity and restricted diffusion in frontal lobe. Axial maximum intensity projection phase contrast MRV (C) shows absent flow in right sphenoparietal sinus (red arrow). Contrast-enhanced axial magnetization-prepared rapid gradient-echo (MP-RAGE), (D) shows filing defect in right sphenoparietal sinus (red arrow).
Figure 3
Figure 3. Axial T2 WI (A) and FLAIR WI (B) show mild volume loss with cystic changes and gliosis in right frontal lobe. Axial maximum intensity projection phase contrast magnetic resonance venography (C) shows recanalization of right sphenoparietal sinus (red arrow).

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