[2] The diagnosis is usually by computed tomography (CT scan) or magnetic resonance imaging (MRI) to demonstrate obstruction of the venous sinuses.

[3][6] Bilateral sixth cranial nerve palsies may occur, causing abnormalities related to eye movement, but this is rare.

[3] Focal neurologic deficits may occur hours to days after the headache in 50% of cases, this may present as hemiparesis (unilateral weakness) if due to infarction of the frontal or parietal lobe which are drained by the vein of Trolard.

[6][9] In children, head and neck infections and acute systemic illnesses are the primary cause of central venous thrombosis.

Cerebral edema and venous infarction may be apparent on any modality, but for the detection of the thrombus itself, the most commonly used tests are computed tomography (CT) and magnetic resonance imaging (MRI), both using various types of radiocontrast to perform a venogram and visualise the veins around the brain.

[3] Computed tomography, with radiocontrast in the venous phase (CT venography or CTV), has a detection rate that in some regards exceeds that of MRI.

MRI has the advantage of being better at detecting damage to the brain itself as a result of the increased pressure on the obstructed veins, but it is not readily available in many hospitals and the interpretation may be difficult.

[11] Cerebral angiography may demonstrate smaller clots than CT or MRI, and obstructed veins may give the "corkscrew appearance".

[3] This, however, requires puncture of the femoral artery with a sheath and advancing a thin tube through the blood vessels to the brain where radiocontrast is injected before X-ray images are obtained.

The thrombosis of the veins themselves causes venous infarction (damage to brain tissue due to a congested and therefore insufficient blood supply).

Thrombosis of the sinuses is the main mechanism behind the increase in intracranial pressure due to decreased resorption of cerebrospinal fluid (CSF).

In cases of VITT, intravenous immune globulins (IVIG) are recommended as they block the anti-PF4 antibody interaction with platelets and a non-heparin anticoagulant.

[20] Raised intracranial pressure, if severe or threatening vision, may require therapeutic lumbar puncture (removal of excessive cerebrospinal fluid), or neurosurgical treatment (optic nerve sheath fenestration or shunting).

[22] In 2004 the first adequately large scale study on the natural history and long-term prognosis of this condition was reported; this showed that at 16 months follow-up 57.1% of people had full recovery, 29.5%/2.9%/2.2% had respectively minor/moderate/severe symptoms or impairments, and 8.3% had died.

[3] A 1995 report from Saudi Arabia found a substantially larger incidence at 7 cases per 100,000; this was attributed to the fact that Behçet's disease, which increases risk of CVST, is more common in the Middle East.

[30] In the 1940s, reports by Dr Charles Symonds and others allowed for the clinical diagnosis of cerebral venous thrombosis, using characteristic signs and symptoms and results of lumbar puncture.

[31][32] Improvements on the diagnosis of cerebral venous sinus thrombosis in life were made with the introduction of venography in 1951,[33] which also aided in the distinction from idiopathic intracranial hypertension,[34] which has similar presenting signs and symptoms in many cases.

[36] A causal link with the vaccine, however, had not been proven, but the EMA decided to conduct further analysis and to inform recipients of the remote possibility of such rare syndromes.

[40] The British Medicines and Healthcare products Regulatory Agency (MHRA) confirmed 79 cases of thrombosis, including 19 fatalities, within the first 20 million vaccinations in Great Britain.

[43] On 13 April 2021 the Centers for Disease Control and Prevention paused the use of the Janssen COVID-19 vaccine in the United States due to six cases of CVST that occurred 6 to 13 days after administration.

[45] U.S. Secretary of State Hillary Clinton was hospitalized on 30 December 2012, for anticoagulation treatment of venous thrombosis of the right transverse sinus, which is located at the base of the brain.

Clinton's thrombotic episode was discovered on an MRI scan done for follow-up of a cerebral concussion she had sustained 2.5 weeks previously, when she fell while suffering from gastroenteritis.