BMJ Case Reports 2018; doi:10.1136/bcr-2017-222781
  • Images in…

Bleeding or clotting: an intracranial dilemma

  1. Rahul Bhatnagar2
  1. 1Intensive Care Unit, Capital & Coast District Health Board, Wellington, New Zealand
  2. 2Academic Respiratory Unit, University of Bristol, Bristol, UK
  1. Correspondence to Dr Rahul Bhatnagar, rahul.bhatnagar{at}
  • Accepted 9 December 2017
  • Published 8 February 2018


We present a complex diagnosis of a 25-year-old woman with a background of ulcerative colitis (UC) at risk of both intracranial haemorrhage and thrombosis.

The patient presented to the emergency department having collapsed at work, obtaining a head injury while falling to the floor and suffering an 8 min seizure in the immediate aftermath. The patient had an acute flare of her UC 2 weeks previously, and her medical history included a deep vein thrombosis following a long-haul flight and a pulmonary embolism while taking contraceptive pill/oral contraceptives.

The patient denied a headache preceding her collapse, although she admitted her head had ‘felt fuzzy’ during …

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