Left middle cerebral artery and sigmoid sinuses thrombosis in a female patient with Crohn's disease
1 Faculty of Medicine, Al-Quds University, Jerusalem, State of Palestine.
2 Department of Internal Medicine, Hamad Medical Corporation, Qatar.
3 Radiology Department, Al Ahli Hospital, Hebron, State of Palestine.
Case Study
World Journal of Advanced Research and Reviews, 2024, 22(01), 069–073
Publication history:
Received on 22 February 2024; revised on 28 March 2024; accepted on 31 March 2024
Abstract:
Introduction: Neurologic manifestations in patients with inflammatory bowel disease (IBD) appear to be more common than in the past. However, vascular events in IBD are still a rare presentation and were reported in few cases.
Case presentation: A 48-year-old female patient known case of Crohn’s disease presented with sudden onset aphasia, headache, blurring of vision, and decreased level of consciousness for 2 hours. The patient looked ill, confused, agitated, and aphasic. Neurologic examination shows dysarthria and 0/5 power of the right upper and lower extremity. A brain CT without contrast was ordered and showed acute ischemic stroke. The patient received tPA (alteplase) immediately in the intensive care unit and was under observation. On admission, brain CT angiography, MRI, and MRV were performed, which showed middle cerebral artery and sigmoid sinuses thrombosis. The patient has undergone cerebral catheterization, and an MCA stent was inserted. Post catheterization, the patient’s right-sided extremity power was improved to 3/5. She was discharged from the hospital after 13 days in good general condition except for her expressive aphasia.
Conclusion: To the best of our knowledge, here we report the first case presented with both; cerebral venous sinus thrombosis and cerebral arteries thrombosis in a patient with IBD. Clinicians must be considered ischemic stroke in any patients with IBD presented with acute neurological manifestation, and an urgent interventional approach must be performed.
Keywords:
Middle Cerebral Artery Thrombosis; Sigmoid Sinuses Thrombosis; Crohn's Disease; Inflammatory Bowel Disease; Case Report; Ischemic Stroke
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