Case Report
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World J Gastroenterol. Feb 7, 2013; 19(5): 773-775
Published online Feb 7, 2013. doi: 10.3748/wjg.v19.i5.773
Internal carotid thrombus in patients with inflammatory bowel disease: Two cases
Sébastien Richard, Gioia Mione, Julien Perrin, Marie Toussaint-Hacquard, Jean-Christophe Lacour, Xavier Ducrocq
Sébastien Richard, Gioia Mione, Jean-Christophe Lacour, Xavier Ducrocq, Department of Neurology, CHU Nancy, Hospital Central, 54035 Nancy Cedex, France
Julien Perrin, Marie Toussaint-Hacquard, Department of Biological Hematology, CHU Nancy, hôpitaux de Brabois, rue du Morvan, 54511 Vandoeuvre-les-Nancy Cedex, France
Author contributions: Richard S and Mione G contributed equally to this work; Richard S, Mione G, Perrin J, Toussaint-Hacquard M, Lacour JC and Ducrocq X designed and performed research; Richard S, Mione G, Perrin J and Toussaint Hacquard M analyzed data; Richard S and Mione G wrote the paper.
Correspondence to: Sébastien Richard, PhD, Department of Neurology, CHU Nancy, Hospital Central, 29 avenue du Marechal de Lattre de Tassigny-CO n° 34, 54035 Nancy Cedex, France. s.richard@chu-nancy.fr
Telephone: +33-3-83851656 Fax: +33-3-83851159
Received: October 4, 2012
Revised: October 25, 2012
Accepted: November 6, 2012
Published online: February 7, 2013
Processing time: 125 Days and 9.9 Hours
Abstract

Increased ischemic stroke risk is observed in patients with inflammatory bowel disease (IBD). Causes and physiopathological aspects of cerebral infarct, in this specific population, are less often described. There is little information to provide guidelines for the best curative and preventive treatment. We report 2 cases of ischemic strokes due to internal carotid thrombus in patients during active phase of IBD. Ulceration of early atherosclerotic plaques activated by a hypercoagulation state may cause a thrombus. A combined therapy with heparin and corticosteroids was used for both our patients. Lysis of the thrombus was obtained after several days without surgical treatment and shown by ultrasonography. These cases highlight an aetiology of stroke in patients with IBD and use of a synergic treatment to respond to hypercoagulability in link with IBD. Benefits and safety of this therapy should be confirmed with clinical studies.

Keywords: Inflammatory bowel disease; Ischemic stroke; Carotid thrombus; Hypercoagulable state; Atherosclerosis