Trombosis venosa cerebral en la enfermedad de Crohn refractaria a tratamiento: aportación de un caso y revisión de una serie de casos pediátricos

Abstract

Introduction

Neurological manifestations in patients with inflammatory bowel disease are more frequent than previously believed. In some cases the neurological symptoms can precede the diagnosis of inflammatory bowel disease. An early and correct diagnosis of these problems is important, since they can be serious and irreversible. Cerebrovascular involvement is rare, being more frequent in ulcerative colitis, and is favoured by a multifactorial hypercoagulability state.

Patients and methodology

The case is presented on a paediatric patient with refractory Crohn's disease who developed cerebral venous thrombosis three years after onset of the bowel disease. A review is also presented on all the cases described in the literature and a comparative study with our case was performed.

Results

The review found a total of 18 paediatric age patients diagnosed with inflammatory bowel disease who suffered thrombosis of the cerebral venous sinuses. Most of the patients had ulcerative colitis (61.1%). An analysis was made of the presence of the most common risk factors such as thrombocytosis or iron-deficiency anaemia, as well as genetic coagulation disorders. The treatment used in the most of the cases included heparin and oral anticoagulants. The outcome of the neurological manifestations was favourable in more than 75% of the cases.

Conclusion

Cerebrovascular involvement is rare, but an early diagnosis and treatment are essential for a favourable outcome.