Cerebral sinus thrombosis, although uncommon, can be lethal if not recognized and treated quickly. Systemic heparin has become the treatment standard of care; however, some patients' conditions continue to deteriorate even while taking heparin. Endovascular techniques for thrombolysis have continued to evolve. The authors present a case of cerebral sinus thrombosis treated with a combination of mechanical and chemical intrasinus thrombolysis.