We report on a patient with nephrotic syndrome who developed superior sagittal sinus thrombosis. He presented with double vision due to bilateral sixth-nerve palsy and papilledema. The thrombosis resolved with intravenous heparin and oral corticosteroids. A month later there were no signs of ocular movement paresis, and both optic nerves were normal.

Trochleitis is defined as the inflammation of the trochlea and peri-trochlear region, in particular the sheath of the superior oblique muscle; being bilateral is an extremely rare event. We think that is important to bear in mind for physicians as a remote possibility in ruling out causes of headache.