Abstract
Pediatric cerebral venous sinus thrombosis (CVST) is a rare complication of ulcerative colitis. Ulcerative colitis is a form of inflammatory bowel disease which accentuates hypercoagulation, thereby leading to thrombosis. Herein, we report a case of a 10-year-old girl who presented with chief complaints of headache, confusion, and new-onset seizure activity for one month as progressively worsening sequelae of ulcerative colitis. Her magnetic resonance venogram confirmed thrombosis in the right transverse, sigmoid, and superior sagittal sinus. The acute ulcerative colitis flare was managed with a short course of steroids and anti-inflammatory monoclonal antibody, and CVST got improved with low-molecular-weight heparin (LMWH). Our study emphasizes the emergence of fatal complications of ulcerative colitis in the pediatric population. It also endorses the pivotal role of thromboprophylaxis with LMWH in pediatric CVST patients. Nevertheless, further studies are required to standardize the use of LMWH in clinical practice.
Highlights
Ulcerative colitis (UC) is a form of chronic inflammatory bowel disease (IBD) that affects the large bowel but may have extracolonic manifestations
We report a case of a 10-year-old girl who presented with chief complaints of headache, confusion, and new-onset seizure activity for one month as progressively worsening sequelae of ulcerative colitis
The acute ulcerative colitis flare was managed with a short course of steroids and anti-inflammatory monoclonal antibody, and cerebral venous sinus thrombosis (CVST) got improved with low-molecular-weight heparin (LMWH)
Summary
Ulcerative colitis (UC) is a form of chronic inflammatory bowel disease (IBD) that affects the large bowel but may have extracolonic manifestations. Recent estimates from the United States have observed an incidence of 2 per 100,000 children in the pediatric population (10-19 years of age) [1]. Patients with UC are more likely to have thromboembolic events than the general population [2]. The incidence of cerebral venous sinus thrombosis (CVST) has risen to 0.67 cases per 100,000 children [3]. CVST, an extra-intestinal manifestation of UC, is attributed to a high risk of morbidity and mortality. The hallmark features of CVST include headache, seizures, altered consciousness, isolated intracranial hypertension, and diffuse encephalopathy, which are non-specific and make diagnosis challenging [4]
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