There is an increased incidence of central nervous system thromboembolic events in young patients with inflammatory bowel disease. A 33-yr-old woman previously diagnosed with pseudotumor cerebri suffered superior sagittal and transverse sinus thromboses during a severe flare of ulcerative colitis. These were documented on contrast computed tomographic (CT) and magnetic resonance imaging (MRI) scans. Stroke may be more common in patients with ulcerative colitis than in patients with Crohn's disease; arterial disease is more prevalent than venous and dural sinus disease, and is correlated with an active phase of inflammatory bowel disease. It is difficult to assess whether there is a relationship to concurrent steroid use, and a consistent relationship to duration of inflammatory bowel disease or to other extraintestinal manifestations is not apparent.