The patient was a 27-year-old male with a 6-year history of ulcerative colitis. He was admitted to the hospital as an emergency with “episodes of right-sided limb immobility with aphasia for 3 days and sudden right-sided limb hemiparesis with aphasia for 2 hours”. Before admission, the patient had recurrent episodes of right-sided limb dyskinesia with inability to speak, lasting from 3 to 10 minutes each time, 2 to 5 times/day, which resolved on their own, without systematic treatment. The patient’s blood pressure was 110/80 mmHg, he had a clear consciousness, wasted appearance, complete motor aphasia, bilateral pupils of equal size and roundness, sensitive light reflex, hypotonia of the right upper and lower limbs, muscle strength grade 0, and right baroreflex sign (+). Hematology: leukocytes 11.13×109/L, erythrocytes 4.34×1012/L, hemoglobin 81g/L, platelets 430×109/L. Coagulation test results: prothrombin time 15.9 sec, prothrombin time 19.5 sec, fibrinogen 1.3g/L. Emergency cranial CT showed punctate hypodense foci in the left frontal and temporal lobes, and the left fissure was slightly narrower than the opposite side. Admission diagnosis: 1. Acute ischemic cerebrovascular disease Left middle cerebral artery thrombosis. 2, ulcerative colitis (total colon type, severe). After admission, a whole brain angiography (DSA) was performed under local anesthesia in an emergency. The left middle cerebral artery was completely unremarkable at the beginning of the left middle cerebral artery, and the M1 segment of the left middle cerebral artery was diagnosed to be occluded (see Figure 1). The CT and CTA were repeated 2 days after the operation: cerebral infarction in the left frontotemporal lobe and basal ganglia area, contrast brain staining in the left external capsule area, and narrowing at the beginning of the left middle cerebral artery compared with the contralateral side. After thrombolysis, the patient was treated with nerve nutrition, hyperbaric oxygen and control of colitis, etc. After 2 months, the patient partially recovered the speech function, the muscle strength of right lower limb grade IV, and the muscle strength of right upper limb grade III. After 3 years of follow-up, the symptoms of colitis were controlled, there was no recurrence of cerebral embolism, the speech function was completely restored to normal, the muscle strength of the right limb was grade V, and the muscle strength of the right hand was grade IV. The literature shows that the prevalence of cerebrovascular embolism is low, and the trend is toward younger age, which can lead to serious neurological deficits or even death, and prevention is especially important. Once the symptoms of embolism appeared, timely consultation and restoration of blood supply to the embolized area within the treatment window maximized the avoidance of massive cerebral infarction, provided the basis for later functional rehabilitation, and maximized preservation of neurological function.