2019 Volume 41 Issue 4 Pages 287-292
A 41-year-old man with ulcerative colitis and antiphospholipid antibody syndrome as the underlying disease was taken the direct oral anticoagulant for a history of repetitive deep venous thrombosis, which was temporarily stopped because of the recent bloody stool. As the pulmonary embolism was occurred immediately after the discontinuation of the anticoagulant, the patient was hospitalized and the intravenous heparin administration was started. Headache and the left hemiparesis were suddenly appeared on the day six of the hospitalization. Magnetic resonance images revealed a cerebral infarction on the right parietal lobe and the thrombus in the sagittal sinus and the transverse sinus. The patient was diagnosed with cerebral venous sinus thrombosis. On the following day, decompressive craniectomy was performed for acute brain swelling from the expanded bilateral cerebral hemorrhagic infarction. Unfortunately, the patient was died on the day nine of the hospitalization. Eventhough either ulcerative colitis or antiphospholipid antibody syndrome can be a risk of thrombosis, report of thrombosis concurrent with the two diseases is extremely rare and only four cases have been reported in the literature. We reported another rare case with literature review.
