Ulcerative colitis (UC) is a long-standing inflammatory bowel disease (IBD) predominantly affecting the colon. UC patients commonly develop extraintestinal manifestations, one of which is venous thromboembolism, which can reach the cerebral venous sinuses and result in cerebral vascular thrombosis (CVT). CVT is potentially life-threatening and may manifest as headaches, seizures, or other neurological symptoms.

Of 1156 studies, 39 were included for analysis, comprising 47 patients aged 2-60 years, with the majority being adult males (33.3%). Patients commonly presented with a headache (67.4%) and for analysis were divided based on the number of presenting symptoms. Subgroup analysis showed that the multi-symptom group commonly presented in adults (66%; p=0.038) and usually observed during a flare-up of UC (56.4%). They also more likely involved the straight and sphenoid sinus compared to the single-symptom group (P < 0.001). Results indicated a poorer clinical status among anemic groups (p=0. 009). We observed that CT imaging was the most frequently used initial modality, whereas MRI was the most sensitive. Low molecular weight heparin was effective in modifying prognosis along with warfarin, and endovascular thrombectomy.