A 30-year-old female was admitted to the hospital with a severe headache and repeated vomiting. apart from a history of long term OCP, the patient's past medical history was unremarkable and there was no history of trauma. Otoscopy showed no abnormality of the ears. Routine blood chemistry revealed no abnormalities.

The patient underwent an emergency head multidetector computed tomography (MDCT) without intravenous contrast demonstrated no tumor or hemorrhage. The straight sinus was more hyperdense and this is a direct sign of thrombosis and a CECT, which confirmed the diagnosis.

CT imaging findings were compatible with thrombosis of the straight sinus thrombosis. Further evaluation of the findings was decided and magnetic resonance imaging (MRI) was performed. Contrast-enhanced T1WI confirmed a lack of flow.

After 3 months on anticoagulants treatment and follow up show totally resolved previously noted filling defect thrombus at straight sinus and complete canalization with return normal flow within and no residual filling defects currently.

It is important to recognize subtle imaging findings and indirect signs that may indicate the presence of thrombosis.