Cerebral venous sinus thrombosis in the postpartum period as an initial presentation of ulcerative colitis: a case report

Cerebral venous sinus thrombosis is an uncommon cerebrovascular disorder with diverse presentations, often affecting young women in the peripartum period due to hypercoagulability. Inflammatory bowel disease is a recognised prothrombotic condition, although the coexistence of cerebral venous thrombosis is exceedingly rare. We describe a 27-year-old primiparous woman who is one month postpartum, presenting with a generalised tonicclonic seizure. Imaging revealed a frontal lobe venous haemorrhage with superior sagittal sinus thrombosis. Her history was notable for intermittent bloody, mucoid diarrhoea since late pregnancy. Postpartum sigmoidoscopy showed severe colitis with obscured vascular pattern, mucosal granularity, shallow ulcers, and spontaneous bleeding, while histopathology confirmed ulcerative colitis. She was anticoagulated for venous thrombosis and achieved remission of colitis with corticosteroid therapy. This case illustrates the unusual intersection of obstetric physiology, systemic inflammation, and gastrointestinal disease. It emphasises the importance of considering inflammatory bowel disease in postpartum women presenting with thrombotic complications and gastrointestinal symptoms.