We present two cases of acute thrombosis of the internal cerebral vein
s, vein of Galen, and straight sinus without sagittal sinus involvemen
t. Both patients had hydrocephalus and severe edema of the basal gangl
ia and thalami, one with hemorrhagic infarction of the thalamus. Becau
se both patients rapidly deteriorated to a comatose state, endovascula
r thrombolysis was performed with urokinase infusion of the deep venou
s structures. Thrombolysis was continued until a patent channel with b
risk flow in the venous structures was achieved. Both patients survive
d with minimal neurologic deficits.