Department of Neurology, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
Perm J. 2021 Jun 2;25:21.031. doi: 10.7812/TPP/21.031.
Cerebral venous sinus thrombosis (CVST) is a rare extraintestinal manifestation of inflammatory bowel disease (IBD), and the risk of poor clinical outcomes remains high in patients with delayed CVST diagnoses. This study aimed to highlight the need to recognize the critical nature of CVST complications in IBD and the challenges associated with managing concurrent conditions. We retrospectively reviewed previously reported cases of CVST in patients with IBD by searching the PubMed, Web of Science, and Google Scholar databases for articles published between 2013 and 2020. Our search identified 35 cases of IBD complicated by CVST. The mean patient age was 24.6 years (range, 31 months-47 years; men > women, ratio, 1.18:1). CVST was 3.8 times more common among patients with ulcerative colitis than among those with Crohn's disease. Active IBD was reported in 91.4% of patients. The mean interval between IBD diagnosis and CVST occurrence was 3 years (range, 2 days-16 years). Headache was the most frequently reported symptom (85.7%), and involvement of multiple sinuses was reported in almost two-thirds of the patients. Corticosteroid therapy at the time of the CVST event was the most common prothrombotic risk factor, present in 57.14% of patients. The overall recovery rate after treatment was 77.14%; whereas the bleeding complication rate was 10%. This review provides essential information that can aid clinicians in making earlier diagnoses and promotes preventive strategies for CVST in patients with IBD. Given that CVST management can be challenging in these patients, a multidisciplinary approach is warranted.
脑静脉窦血栓形成(CVST)是炎症性肠病(IBD)的一种罕见的肠道外表现,而 CVST 诊断延迟的患者临床结局不良的风险仍然很高。本研究旨在强调需要认识到 CVST 并发症在 IBD 中的严重性,以及管理并存疾病所面临的挑战。我们通过检索 PubMed、Web of Science 和 Google Scholar 数据库,查找 2013 年至 2020 年期间发表的关于 IBD 合并 CVST 的病例报告,对先前报道的 IBD 合并 CVST 的病例进行了回顾性研究。我们的检索共确定了 35 例 IBD 合并 CVST 的病例。患者的平均年龄为 24.6 岁(范围:31 个月-47 岁;男性>女性,比例为 1.18:1)。溃疡性结肠炎合并 CVST 的比例是克罗恩病的 3.8 倍。91.4%的患者存在活动期 IBD。IBD 诊断与 CVST 发生之间的平均间隔时间为 3 年(范围:2 天-16 年)。头痛是最常见的症状(85.7%),近三分之二的患者累及多个窦。CVST 事件时使用皮质类固醇治疗是最常见的促血栓形成危险因素,占 57.14%的患者。治疗后的总体恢复率为 77.14%;而出血并发症的发生率为 10%。本综述提供了重要信息,可以帮助临床医生更早地做出诊断,并促进 IBD 患者的 CVST 预防策略。鉴于这些患者的 CVST 管理具有挑战性,因此需要多学科方法。