Background: The risk of thrombosis is high in patients with Ulcerative Colitis. The main location of thrombosis is in the extremity and pulmonary vein. Cerebral venous thrombosis is a rare location for thrombosis with high mortality. One of the risk factors for developing thrombosis is in association with surgery, especially during an active phase of Ulcerative Colitis (UC), and very few studies report cases occurring during the inactive phase. Hence, it is important for the surgeon to understand the risk of thrombosis, especially of cerebral sinus thrombosis in the Ulcerative Colitis patient. Case: We are presenting a fatal complication in a male patient of 62, who had sagittal sinus thrombosis and multiple intra-cranial hemorrhages in both frontal lobes 3 weeks after microvascular decompression surgery for hemifacial spasm. Conclusion: The risk of cerebral venous sinus thrombosis is higher in Ulcerative Colitis patients, especially in those who undergo surgery regardless of its type. Careful peri-operative assessment and treatment related to thromboembolism prevention are important to reduce complications in such cases.
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