Always look for dural venous sinuses when relatively normal brain is seen in a patient with severe headache. The high signal intensity in pulse sequences alerted me first. The diffusion restriction raised the suspicion of intra-luminal thrombus. I went ahead and did a venogram to identify the absence of filling. Reviewing axial T1 weighted image enabled me to pick up the obvious asymmetry in the skull base which is one of the hidden areas of a brain study. I alerted the MR technician to do a i.v. gadolinium contrast study and a contrast enhanced venogram to reaffirm the findings. 

The malignant left occipital condyle lytic neoplasm has resulted in the venous thrombosis. The sluggish flow in the hypoplastic left transverse sinus is responsible for the high signal intensity in all pulse sequences.