DR. RASHMI HG

Abstract

Purpose:To report an unusual case of DVA thrombosis at occipital lobe in Crohns disease Patient

Method: 27 year old female Presented with sudden diminution of vision of both eyes,left sided paresthesia in upper and lower limb.K/C/O of crohns disease from 1yr,was on tab.mesalamin,patient was in severe flare up during presentation.MRI brain revealed Right occipital lobe infarct with MR angiography normal,raised ESR.Stroke in young workup was done in detail.

Result:MTHFR mutation was positive for heterozygous mutation.So,patient was adviced antiplatelets and folic,vit.B12 supplementaion lifelong,discharged.Repeat MRI brain after 1 year showed DVA at occipital lobe which was missed earlier. Hence,patient was put on anticoagulants and adviced followup.

Discussion: Ophthalmic manifestation,thrombosis of DVA are rare complication of crohns disease.Inflammation associated with inflammatory bowel disease may promote the release of prothrombotic factors which might lead to ischemic strokes.