CASE PRESENTATION: A 25 year old male with ulcerative colitis (UC) presented with complaints of left hand numbness, which began 12 hours prior. The patient said that his left side from neck to fingers felt as if it was asleep. The sensation had started in his fifth finger then progressed throughout his hand. He also complained of left chest tingling. Initial vital signs were significant for a temperature of 102, HR 102. Cranial nerves were intact and extremity strength was full bilaterally. Sensation was decreased to light touch over left arm. 12 hours after presentation the patient found he was unable to move his left leg, and 18 hours after presentation he was unable to lift his arm and leg against gravity. MRI was significant for dural venous sinus thrombosis involving the confluence of sinuses and cerbral cortical vein.