Cerebral Venous Thrombosis as a Complication of Ulcerative Colitis: A Case Report

Abstract

Chronic inflammatory bowel diseases (IBD), like other systemic inflammatory diseases, are associated with an increased risk of venous and arterial thromboembolic complications. This risk is closely correlated with disease activity. Deep-vein thrombosis and pulmonary embolism are the most common manifestations. A cerebral venous sinus thrombosis may rarely occur identified by cerebral MRI in the presence of suggestive symptoms. Therapeutic management is based on anticoagulant therapy, the duration of which depends on associated venous thromboembolic risk factors, which should be identified in all IBD patients. Thromboembolic events represent a major cause of morbidity and mortality, so the overall management of IBD patients must actively integrate the prevention of these complications. We report the case of a 32 years-old female patient with distal UC on azathioprine, hospitalized with a moderate flare-up of her disease, presenting with intense headache, photophobia, followed by a febrile tonic-clonic convulsive seizure with paresthesia of all 4 limbs and left facial paralysis, revealing on cerebral MRI a venous thrombosis of the superior longitudinal sinus and right lateral sinus responsible for an oedemato-hemorrhagic remodelling. The patient received anticoagulant therapy based on low-molecular-weight heparin followed by vitamin K antagonists (VKA). The course was favorable, with complete clinical and radiological remission.