Stroke in paediatric Crohn’s disease

Neurological complications in inflammatory bowel disease are rare but can increase morbidity. The risk is higher in poorly controlled disease with recurrent flare-ups.We discuss an adolescent girl with difficult-to-treat Crohn's disease (CD) complicated by haemorrhagic stroke. While she was under treatment for an episode of flare-up, she developed haemiparesis, facial nerve palsy and focal seizures. In the past, she had experienced multiple admissions for recurrent abdominal pain and altered bowel habits. A thorough evaluation confirmed the diagnosis of CD. Though her disease status required administration of biologicals in the initial phase, due to financial constraints, it was not possible. In the present admission for a relapse, she developed a stroke. Neuroimaging with angiography suggested infarction with haemorrhagic transformation in the left posterior parietal lobe and thrombosis of the superior sagittal sinus and left transverse sinus.Emergency stabilisation was done with antiepileptics and anticoagulants. She was initiated on infliximab during the rehabilitation phase. The primary disease is under partial remission, and facial and limb weaknesses have recovered completely.