With the advent and increasing availability of neuroimaging in the past few decades, cerebral venous thrombosis (CVT) has become a more easily recognized disease and appears to be more common than previously believed. Despite this, CVT remains a diagnostic and therapeutic challenge. The true incidence of CVT remains unclear. In the past the diagnosis of CVT was largely made at autopsy, leading many to believe that most cases were fatal. Early series based on angiographic diagnosis estimated mortality to be thirty to fifty percent (1,2). More recent series, however, have estimated mortality at 6–33%. Improvement in magnetic resonance imaging (MRI) and magnetic resonance venography (MRV) techniques have led to an increase in premorbid diagnosis and it has become clear that CVT is more common than previously thought. More recent studies have found death rates ranging between 5 and 30% (3–7). Furthermore, a wide range of disease symptomatology and severity may be present (3,5,8). Although this may make CVT more difficult to diagnose, recent studies suggesting effective therapy underscore the importance of prompt recognition of this elusive, but treatable cause of neurologic deterioration