Young-onset stroke complicating ulcerative colitis

Pract Neurol. 2022 Jun;22(3):220-223. doi: 10.1136/practneurol-2021-003106. Epub 2022 Jan 7.

Abstract

A 16-year-old girl developed a proximal occlusion of the right middle cerebral artery during a flare-up of acute ulcerative colitis. Although mechanical thrombectomy led to successful middle cerebral artery recanalisation, she required an immediate second thrombectomy due to reocclusion of the same arterial segment. She developed a second ischaemic event 7 days later despite intravenous heparin infusion, later switched to low-molecular-weight heparin, and a third event after 3 days despite the addition of aspirin. We discuss stroke risks in people with inflammatory bowel disease and the uncertainties around anticoagulation and antiplatelet regimens in such cases.

Keywords: MRI; cerebral blood flow; cerebrovascular disease; medicine; stroke.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Colitis, Ulcerative* / complications
  • Female
  • Humans
  • Stroke* / complications
  • Stroke* / diagnostic imaging
  • Thrombectomy
  • Treatment Outcome