Cerebral Thrombosis Complicating Crohn's Disease: Two Cases

Cerebrovenous thrombosis is quite rare in infammatory bowel disease. There are only a few reports of this association in the literature. We report 2 cases of patients with Crohn's disease (CD) who developed cerebral thrombophlebitis confirmed by neuroimaging. The first case was a 35-year-old man with a history of CD who presented with acute confusion. Brain magnetic resonance imaging demonstrated a left temporoparietal infarction and thrombosis of the left lateral sinus. Coagulation studies showed a marked protein S deficiency. His condition improved significantly after initiation of anticoagulant therapy. The second case was a 38-year-old woman who was admitted for a sudden loss of consciousness with tetraplegia. Brain computed tomography revealed a profound cerebrovenous thrombosis. She died within a few days after admission. Inflammatory bowel disease carries an increased risk of venous and arterial thrombosis. Although the pathogenic mechanisms of this predisposition are unclear, a possible role of inherited risk factors for thrombosis in determining this predisposition has been suggested. In these cases, both fibrinolysis and coagulation are activated as well.