Intestinal Research  
A case of ulcerative colitis presenting with cerebral venous thrombosis
Junghwan Lee1,2, Sung Wook Hwang1, Jinhee Lee2, Kyung Hwa Jung2, Ha Il Kim2, Sang Hyoung Park1, Dong-Hoon Yang1, Byong Duk Ye1, Jeong-Sik Byeon1, Seung-Jae Myung1, Suk-Kyun Yang1
Departments of 1Gastroenterology and 2Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Correspondence to: Sung Wook Hwang, Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea Tel: +82-2-3010-3195, Fax: +82-2-476-0824, E-mail: snow903@gmail.com
Received: June 29, 2017; Revised: August 6, 2017; Accepted: August 15, 2017; Published online: September 29, 2017.
© Korean Association for the Study of Intestinal Diseases. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Patients with inflammatory bowel disease (IBD) have been reported to have an increased risk of thromboembolism. Cerebral venous thrombosis (CVT) is a rare but serious extra-intestinal manifestation of IBD. Due to its highly variable manifestation and low incidence, CVT is not usually readily recognized by physicians. Herein, we report a case of a 35-year-old male presenting with CVT associated with ulcerative colitis (UC). The patient was admitted with chief complaints of bloody diarrhea that had started 3 days prior. Sigmoidoscopy showed hyperemic and edematous mucosa, friability, and shallow ulcers from the sigmoid colon to the rectum suggestive of IBD. Three days later, the patient started complaining of a headache, and gradually developed a decreased level of consciousness. Magnetic resonance imaging of the brain revealed CVT with hemorrhagic infarctions. An angiogram was obtained to evaluate the extent of CVT, and anticoagulation therapy was initiated with intravenous heparin. During hospitalization, he was diagnosed with UC and treated with 5-aminosalicylic acid. After discharge, the patient was recovered without neurological deficit, and remission of UC was also obtained. The presence of headache or acute worsening of neurological status in a patient with IBD should alert the health professionals about the possibility of CVT.
Keywords: Inflammatory bowel disease; Colitis, ulcerative; Cerebral venous thrombosis; Complications; Thromboembolism


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