Recurrent Cerebral Hemorrhage Associated with Ulcerative Colitis

Abstract

Ulcerative colitis (UC) is a rare cause of stroke. Most such cases result from cerebral venous thrombosis, and cerebral vasculitis is one cause of venous thrombus formation. Here, we report a patient with UC who experienced recurrent cerebral hemorrhage. A 53-year-old Japanese woman with UC presented with sudden onset of disorientation and sensory aphasia. Brain computed tomography revealed cerebral hemorrhage in the left temporal lobe. She had a history of UC for two decades but had discontinued her medication. On the fifth hospital day, another cerebral hemorrhage occurred in the right occipital lobe. After steroid therapy, these abnormal findings on MRI improved within a short time, and she was discharged from hospital with no sequelae. Physicians should be alert to cerebral hemorrhage in patients with UC, consider cerebral vasculitis as an etiology, and treat with steroid therapy for a good outcome.