A 52-year-old lady presented to the emergency department with mild headache and anomic aphasia progressing to expressive aphasia. Computed tomography (CT) scan of the brain revealed parenchymal haemorrhage in the left temporoparietal region and suspicion of a left transverse sinus thrombosis. CT venogram of the brain showed extensive thrombus at the left transverse sinus, sigmoid sinus and internal jugular vein. This rare condition should be considered in CT scan showing haemorrhagic changes. Anti-coagulation is the mainstay of treatment of this once highly deadly disease. (Hong Kong j.emerg.med. 2014;21:172-175)
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