The cerebral thromboembolic disease is a rare extraintestinal manifestation of the ulcerative colitis. but it is one of the major causes of death in patients with ulcerative colitis. The outcome in cerebral venous thrombosis is poor, leading to death or major neurological sequelae in about 60% of patients. A 27-year old female with a 6-year history of ulcerative colitis episodically developed seizure for one month. Brain MRI showed cerebral infarction with old hemorrhage in the left frontotemporal hemisphere. Cerebral angiography showed no evidence of vasculitis or atheromatous cbange. Cardiac echocardiogram and radionuclide venography of the lower extremities revealed no evidence of thrombi. Tests for coagulation abnormality were also normal. She was managed with antiplatelet agent and antiepileptics. In addition, total proctocolectomy was performed for the patient. (Kor J Gastroenterol 1998;32:396 - 401)