A case of cerebral thromboembolism in ulcerative colitis / 대한내과학회지

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.