A 22-year-old woman with advanced AIDS presented with altered mental status. A brain magnetic resonance imaging and angiogram showed extensive dural sinus thromboses of the sagittal and bilateral transverse sinuses. CD4 level was low (<15/mm3) and a significant low protein S (7%; normal 54-137%) and C (41%; normal 72-147%) levels were detected. No other hypercoagulable factors were identified. Successful treatment was done with heparin and plasminogen activator catheter-directed thrombolysis were administered. A variety of haematological abnormalities have been observed in human immunodeficiency virus infection. Advanced AIDS might be considered as an acquired hypercoagulable state.