The pathogenesis of otitic hydrocephalus still remains doubtful. Magne
tic resonance imaging (MRI) demonstrated sigmoid and transverse sinus
thrombosis in two consecutive patients. The role of MRI in the diagnos
is and pathogenesis of this complication, together with literature fin
dings, is discussed. Until now lumbar puncture, which is a minimally i
nvasive technique, was the only diagnostic measure. MRI, however, can
be used to establish the diagnosis of otitic hydrocephalus by showing
the thrombosis in the sigmoid and transverse sinus.