The case of a patient with partial superior sagittal sinus and partial right sided transverse sinus thrombosis, and posterior fossa venous collaterals is presented. We report on the use of venous transcranial colour-coded duplex sonography (TCCS), combined with a new three-dimensional transcranial duplex data acquisition system, which allows free hand scanning of the region of interest. TCCS with three-dimensional image reconstruction allowed a more precise spatial localization of venous flow signals in the posterior fossa and facilitated the understanding of the haemodynamics of the venous collateral network.