Case description: Patient, male, 28 years old, athlete, physically fit, had occasional episodes of headache and transient blurred vision 1 month ago, without examination and treatment at the hospital. 1 day before admission, the headache worsened and vomiting occurred. On admission, head CT: right occipital and posterior cranial fossa subdural hemorrhage, given antihemorrhage and antiemetic treatment, on the third day the patient had a grand mal seizure, resulting in a persistent state of epilepsy, delirium, frequent intravenous valium, the effect was not satisfactory, rechecked head CT: frontal lobe cerebral edema, a small amount of intracerebral hemorrhage in the left parietal and right temporal lobe, about 10 ml, lumbar puncture measured intracranial pressure greater than 400 mmH2O, fundus without optic papilla edema, consider venous sinus thrombosis. On the third day of admission, a whole brain angiogram was performed under general anesthesia, which confirmed complete occlusion of the sagittal sinus and the right transverse sinus, and the internal carotid artery was slowly injected with 150,000 units of urokinase. After 1 week, the patient had no more seizures, was alert, could communicate with others normally, had normal muscle strength and tone of the limbs, walked normally, ate and defecated by himself, and had the gastric tube and urinary catheter removed. The cerebral edema disappeared. Experience summary: The incidence of venous sinus thrombosis is not high in young people, especially hemorrhagic venous sinus thrombosis is rare, it is difficult to judge under normal circumstances, and it is easy to misdiagnose and mistreat. The patient was treated with intraoperative arterial thrombolysis, postoperative anticoagulation, and monitoring of clotting time to prevent intracranial hemorrhage and rethrombosis. The successful treatment of this patient was due to early judgment and timely cerebral angiography and arterial thrombolysis, as well as careful postoperative management and prevention of various complications, which led to a complete recovery in less than 2 weeks. No sequelae were left behind.