A Case of Syrian Child with Cerebral Infarction as an Extraintestinal Manifestation of Ulcerative Colitis

Table 1

Cases reported in the international of Cerebral Arterial Thrombosis associated with ulcerative colitis.

Author	Date	Sex	Age	UC Activity	IBD Treatment	Neurological symptoms	Site of cerebral injury/neurological findings	Risk Factor	Thrombophilia screening	Anticoagulation/antiplatelet treatment	Follow-up/outcome
Calabro et al. [10]	2011	F	49	No		Right hemiparesis, aphasia, altered conscious	Left frontotemporal infarct, lesion in the left mesencephalic area, left ICA stenosis	Hypercholesterolemia, elevated Lpa		LMWH (nadroparine 0.6 ml/d), aspirin (300 mg/d) / clopidogrel (75 mg/d)	Improved
Casella et al. [11]	2013	M	25	Yes		Left hemiparesis, confusion, sensitive impairment, bladder incontinence	Right MCA infarct	Anemia		Local thrombolysis/ LMWH and aspirin (100 mg/d)	Complete recovery
Chetri et al. [12]	2002	M	42	Yes	Steroids, 5-ASA	Left hemiplegia	Right MCA infarct and right CCA occlusion	Anemia			Improved
Fukuhara et al. [13]	1993	M	18	No	Steroids	Left hemiparesis	Right paramedian branch of the basilar artery infarct, Ventromedial pons	Anemia			Complete recovery
Hilton-Jones et al. [14]	1985	M	20	No			Basal ganglia infarct	Anemia, abnormal platelet aggregation			Recurrent thrombotic episodes, death
Houissa et al. [4]	2011	M	24	Yes	Steroids	Left hemiplegia	Left MCA infarct		Neg	LMWH	Complete recovery
Houissa et al. [4]	2011	F	25	Yes	5-ASA	Left hemiparesis	Tenticular & right thalamic infarcts	Thrombocytosis	Neg	LMWH	Partial recovery (Residual right hemiparesis)
Jorens et al. [15]	1990	M	31	Yes	5-ASA	Right hemiparesis, nonconfluent aphasia	Recent ischemic lesion in left internal capsule and old ischemic lesion in left basal ganglia	Anemia, thrombocytosis, pro-C, pro-S and prothrombin deficiency, history of TIA			Partial recovery
Jorens et al. [16]	1991	M	32	Yes		Left hemiparesis, stupor, hemiataxia	Temporoparietal cerebrovascular ischemic lesion				Complete recovery
Joshi et al. [17]	2008	M	55	Yes	Steroids, 5-ASA	Left hemiparesis	Right parietal lobe infarction	Thrombocytosis	Neg	LMWH	Partial recovery
Joshi et al. [17]	2008	M	24	Yes	Steroids, 5-ASA	Headache, altered conscious, global aphasia	Left MCA infarct	Thrombocytosis	Neg		Complete recovery, subsequent epilepsy
Keene et al. [18]	2001	F	13	Yes	Steroids, subtotal colectomy	Seizure	Multiple bilateral cerebellar and corona radiata infarcts	Anemia			Complete recovery
Kelly et al. [19]	2014	M	38	No	Steroids, AZA, infliximab	bilateral lower limb claudication, acute confusion with associated ataxia and diplopia	right medial temporal lobe extending posterior to the occipital lobe		Neg	Warfarin	Controlled
Lloyd-Still and To masi [20]	1989	M	5	Yes	Steroids, 5-ASA	Right hemiparesis, seizure	Left MCA arteritis	Anemia			Partial recovery, epilepsy developed 10 years later
Mayeux and Fahn [21]	1978	M	17	Yes	Steroids		Right posterior frontal area infarction				Slowly improved
Nogami et al. [22]	2007	F	26	Yes	Steroids	Left hemiparesis	Right MCA Infarct and right CCA occlusion	Severe anemia		Heparin (15.000 U/d)	Massive GI bleeding, no improvement
Paradis et al. [23]	1985	F	12	Yes		Right hemiparesis, seizure	Left major cerebral vessels occlusion	Anemia, thrombocytosis			Complete recovery
Patterson et al. [24]	1971	M	11	Yes			Cerebral emboli				Colectomy
Richard et al. [25]	2014	F	42	Yes	Steroids, AZA	Sudden right hemiplegia	Right MCA	Slight hyperhomocysteinemia		LMWH, Enoxaparin sodium, Aspirin
Salloum et al. (our case)	2016	F	15	No	Steroids, 5-ASA, AZA	Left hemiparesis, 7th CN palsy	M2-M3 segments of the Right MCA	Pancytopenia	Neg	Aspirin 162mg	Colectomy, complete recovery
Schneiderman et al. [26]	1979	M	34	Yes		Right hemiplegia, nonfluent aphasia	Left ICA thrombosis	Thrombocytosis		Thrombectomy, heparin/warfarin
Schneiderman et al. [26]	1979	F	12	Yes	Steroids, 5-ASA	Hemianopia, headache, seizures	Distal basilar artery defect extending to the left PCA	Elevated fVIII			Death
Tomomasa et al. [27]	1993	F	1	Yes	Steroids, 5-ASA	Right hemiplegia, altered conscious, seizures	Left anterior & MCA infarct/ right MCA infarct	Thrombocytosis, bacterial endocarditis			No improvement
Yassinger et al. [28]	1976	F	15	Yes	Steroids		Right frontal lobe infarction				Recovered

M = male; F = female; 5-ASA = 5-aminosalicylic acid; AZA = azathioprine; CN = cranial nerve; ICA = internal carotid artery; MCA = middle cerebral artery; CCA = common carotid artery; PCA = posterior cerebral artery; LPa = lipoprotein; Pro-C = protein C; Pro-S = protein S; TIA = transient ischemic attack; fVIII = factor VIII; LMWH = low molecular weight heparin; GI = gastrointestinal.