Two previously healthy female patients (aged 18 and 49 years) were admitted because of a headache of rapid onset along with vomiting followed by an apathetic state. Neurological status revealed abulia and massive frontal release signs. Acute magnetic resonance imaging showed bilateral thalamic hyperintensities on T2-weighted images (Figure 1) and deep cerebral venous thrombosis was confirmed by venous magnetic resonance angiography.