Venous phase of a CTA in a 19 year old with a history of sinusitis and progressively worsening headache and a fever. Venous phase of a CTA in a 19 year old with a history of sinusitis and progressively worsening headache and a fever. No contrast has reached the cavernous sinuses bilaterally yet the internal carotid arteries are well delineated. The filling defects in the cavernous sinuses represent thrombosis. Adjacent right sided posterior ethmoid air cells are fluid filled, consistent with sinusitis and the cause of the thrombosis. I Bone, and D M Hadley J Neurol Neurosurg Psychiatry 2005;76:iii29-iii38 ©2005 by BMJ Publishing Group Ltd