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Cerebral thrombosis and vasculitis: an uncommon complication of ulcerative colitis
Carmona, M. A; Jaume Anselmi, F; Ramírez Rivera, J.
  • Carmona, M. A; Hospital de La Concepción. Department of Medicine. PR
  • Jaume Anselmi, F; Hospital de La Concepción. Department of Medicine. PR
  • Ramírez Rivera, J; Hospital de La Concepción. Department of Medicine. PR
Bol. Asoc. Méd. P. R ; 92(1/3): 9-11, Jan.-Mar. 2000.
Artigo em Inglês | LILACS | ID: lil-411346
ABSTRACT
Cerebral thrombotic disease is a rare and nearly always fatal complication of ulcerative colitis. It is associated with a necrotizing vasculitis. We report a fatal case with a confusing neurologic picture arising from this complication. Autopsy revealed necrosis and hemorrhages affecting both cortical grey and white matter. Microscopic examination showed thrombosis of small and medium size vessels associated with hemorrhages and a necrotizing angiitis. Ulcerations, hemorrhages, pseudopolyps, and cryptic abscesses were found in the rectosigmoid region of the colon compatible with active ulcerative colitis. A sudden neurologic deficit in a patient with ulcerative colitis should direct attention to the consideration of a cerebral thrombotic event and the possibility of an associated cerebral vasculitis. Diagnosis may be strongly suggested by MRI or arteriography, but it may require confirmation by biopsy of the brain parenchyma and leptomeninges. A hypercoagulable state has been associated with the thrombosis. Anticoagulation has yielded successful results in some patients with cerebral thrombosis but the risk of massive intracranial and gastrointestinal bleeding preclude to establish clear indications. Neurologic improvement has been obtained with the use of steroids and cyclophosphamide
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Índice: LILACS (Américas) Assunto principal: Vasculite / Colite Ulcerativa / Trombose Intracraniana Tipo de estudo: Estudo diagnóstico Limite: Humanos / Masculino Idioma: Inglês Revista: Bol. Asoc. Méd. P. R Assunto da revista: Medicina Ano de publicação: 2000 Tipo de documento: Artigo País de afiliação: Porto Rico Instituição/País de afiliação: Hospital de La Concepción/PR

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Índice: LILACS (Américas) Assunto principal: Vasculite / Colite Ulcerativa / Trombose Intracraniana Tipo de estudo: Estudo diagnóstico Limite: Humanos / Masculino Idioma: Inglês Revista: Bol. Asoc. Méd. P. R Assunto da revista: Medicina Ano de publicação: 2000 Tipo de documento: Artigo País de afiliação: Porto Rico Instituição/País de afiliação: Hospital de La Concepción/PR