Cerebral venous sinus thrombosis as presenting feature of ulcerative colitis

Thrombosis is a well recognized complication of inflammatory bowel disease that occurs in 1.3 to 6.4% of patients, however, cere- bral vascular involvement is unusual. We present the case of a 16- year-old female in whom cerebral venous thrombosis was the pre- senting symptom of an active ulcerative pancolitis. Thrombophilia screen (plasma levels of proteins C and S, antithrombin, antibeta2- glycoprotein, lupus anticoagulant and anticardiolipin antibodies, activated protein C resistance, homocystein level antinuclear anti- bodies) was negative. The patient was successfully treated with anticoagulant therapy, phenobarbital and sulfasalazine. Cerebral venous thrombosis is an exceptional presenting feature of ulcera- tive colitis. Disease activity may play a major role in the occurrence of thrombosis. (Acta gastroenterol. belg., 2009, 72, 350-353).