Cerebral venous sinus thrombosis in patients with inflammatory bowel disease: a retrospective study

Wang Shujun,Bai Xia,Wang Hongjian,Zhang Huijie

doi:10.1038/s41598-021-96541-y

Abstract

Cerebral venous sinus thrombosis (CVST) is a rare and devastating complication of inflammatory bowel disease (IBD). Early diagnosis and prompt treatment could improve prognosis. The aim of our study was to investigate the clinical data and predictive factors of inflammatory bowel disease in patients with a diagnosis of CVST. All IBD patient data were collected from July 2013 and September 2020. Clinical data, predictive factors and prognosis were compared between IBD patients with CVST and the IBD control group. The incidence of CVST in our study was 0.48%. The mean age of IBD patients with CVST was 34.9 years. The average duration of IBD was 4 years when cerebrovascular events occurred. The clinical presentation of CVST included headache (73.1%), vomiting (30.8%), limb dysmetria (26.9%), speech impairment (11.5%), blurred vision (7.7%), epileptic seizures (7.7%) and drowsiness (3.8%). The most common location for CVST was the transverse sinus (61.5%) followed by the superior sagittal sinus (30.8%). Anaemia, low albumin and elevated d-dimer were independent predictors of CVST in patients with IBD. Anticoagulation therapy was effective. The prognosis of IBD patients with CVST was worse than that of IBD patients without CVST. Early identification of the risk and clinical features of CVST in IBD patients is important. Prompt antithrombotic therapy is a safe and effective treatment.

Highlights

Cerebral venous sinus thrombosis (CVST) is a rare and devastating complication of inflammatory bowel disease (IBD)
This study aimed to investigate predictive factors and clinical features of cerebral vascular thrombosis in patients with IBD
Most CVST events occurred during IBD disease flares (96.2%), and only 1 patient (3.8%) experienced CVST events during disease remission

Summary

Introduction

Cerebral venous sinus thrombosis (CVST) is a rare and devastating complication of inflammatory bowel disease (IBD). The aim of our study was to investigate the clinical data and predictive factors of inflammatory bowel disease in patients with a diagnosis of CVST. Predictive factors and prognosis were compared between IBD patients with CVST and the IBD control group. Identification of the risk and clinical features of CVST in IBD patients is important. Abbreviations CVST Cerebral venous sinus thrombosis IBD Inflammatory bowel disease PE Pulmonary embolism UC Ulcerative colitis CD Crohn’s disease SD Standard deviation LMWH Low-molecular-weight heparin VTE Venous thromboembolism LDL-C Low-density lipoprotein cholesterol hsCRP Hypersensitive C-reactive protein 5-ASA 5-Aminosalicylate MRI Magnetic resonance imaging MRV Magnetic resonance venography. Inflammatory bowel disease (IBD) is chronic inflammation of the digestive tube with unknown aetiology.

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