The four patients presented here demonstrate the value of contrast enhanced CT in the diagnosis and serial evaluation of dural sinus thrombosis. Two patients were young women using oral contraceptives; another patient had lateral sinus thrombosis complicating mastoiditis; a fourth patient developed superior sagittal sinus thrombosis following hip surgery. Improvements in CT diagnosis, including the use of thin sections for evaluation of the deep venous structures and lateral sinuses complemented by multiplanar reconstruction or direct coronal scanning, are discussed. Sequential scans for following the progress of two patients treated by barbiturate coma added to the understanding of dural sinus occlusive disease.