Korean J Med.  2009 Oct;77(4):498-502.

A case of cerebral thromboembolism in ulcerative colitis

• Oh JT
• Jeon SW
• Lee EK
• Lee SH
• Jung MK
• Kim SK

Abstract

Although cerebral thromboembolic disease is a rare extraintestinal manifestation of ulcerative colitis, it is one of the major causes of death in patients with the disease. A 29-year-old man who had a 7-year history of ulcerative colitis was admitted to our hospital complaining of nausea, vomiting, bloody diarrhea, and colicky abdominal pain. Fourteen days after admission, he developed sudden-onset left pure motor hemiplegia. Magnetic resonance imaging and angiography revealed an infarction involving the right temporo-occipital hemisphere and diffuse middle cerebral artery territory. Neck computed tomography angiography showed no evidence of cervical carotid or vertebral artery abnormalities, and transthoracic and transesophageal echocardiograms revealed no evidence of thrombi. Factor V was elevated to 176% (normal 50~150%) and protein S antigen had decreased to 57% (normal 60~150%). He was managed with antiplatelet agents and a total proctocolectomy.

Keyword

Ulcerative colitis; Cerebral infarction; Thromboembolism

MeSH Terms

Abdominal Pain
Adult
Angiography
Cause of Death
Cerebral Infarction
Colitis, Ulcerative
Diarrhea
Factor V
Hemiplegia
Humans
Infarction
Magnetic Resonance Imaging
Middle Cerebral Artery
Nausea
Neck
Platelet Aggregation Inhibitors
Protein S
Thromboembolism
Ulcer
Vertebral Artery
Vomiting
Factor V
Platelet Aggregation Inhibitors
Protein S