Infarto ischemico cerebrale e colite ulcerosa: un nuovo caso [Ischemic cerebral infarct and ulcerative colitis: A new case report]

Thromboembolic events are uncommon complications of chronic inflammatory bowel disease (CIBD). These complications, occurring 1,3 to 6,4% in adults and 3,3% in children with CIBD, are associated with a high mortality rate (25%). The cause of these episodes remains unclear: arterial and venous thromboembolism have been reported as a consequence of hypercoagulable state associated with CIBD. In most cases, these complications occur in the active phase of disease but, more rarely, thromboembolic events have been reported during quiescence or remission. Systemic anticoagulant treatment is the approach of choice in patients affected by deep venous thrombosis or pulmonary embolism. An hemorragic infiltrate may be the consequence of the treatment of ischemic stroke with anticoagulants. Immunosuppressive therapy should be administered in patients with systemic vasculitis. In this case report, an ischemic stroke is described in a 28 months old patient with ulcerative colitis. We discuss: a) the epidemiologic aspects of this uncommon complication; b) the pathogenesis and the possible risk factors of thromboembolic accidents; c) the polymorphous clinical aspects; d) the clinical, biohumoral and neuroradiological examinations required for an accurate diagnostic and prognostic assessment.