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Images in Neurology
May 2006

Cerebral Vasculitis in Ulcerative Colitis

Arch Neurol. 2006;63(5):780. doi:10.1001/archneur.63.5.780

Cerebral vasculitis leading to stroke in ulcerative colitis has rarely been reported.1,2 A 35-year-old woman with severe ulcerative colitis receiving cyclosporine and prednisolone sought care for right-sided weakness and unsteady gait lasting for 5 days. Diffusion brain magnetic resonance images showed infarction in the left anterior cerebral artery territory (Figure 1). Digital subtraction angiographic images of the intracranial vessels showed multiple areas of stenosis and dilatation (beaded appearance) involving the left middle cerebral, anterior cerebral, and posterior cerebral arteries (Figure 2). These appearances were strongly suggestive of cerebral vasculitis. Cyclosporine levels were in the nontoxic range. Magnetic resonance angiogram taken 1 month after cessation of cyclosporine showed similar findings.

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