A patient presented for neuroimaging with h/o headache and decreasing vision for eight days. Clinical examination revealed bilateral papilledema.

CT revealed normal neuroparenchyma with pansinusitis. Basal sections through the orbit revealed tortuous optic nerves on both sides.

MRI of brain and orbit done subsequently confirmed the findings seen on CT. In addition, MRI revealed extensive thrombosis of superior sagittal sinus and the right transverse sinus.

Lumbar puncture was performed; the CSF pressure was high (24cm), 30cc of CSF was let out and the patient was heparinised. The patient clinically improved with this therapy.