Nephrotic syndrome is well known for its hypercoagulable state and thrombotic complications. This warrants cautious management of the disease with meticulous monitoring for thrombotic complications as it carries high morbidity and mortality than the original disease itself most often. Here, we present a case of adult onset nephrotic syndrome referred to our centre for further evaluation and management. On detailed work up, she turned out to be a case of minimal change disease. During her recovery period in the hospital she developed headache and diplopia. Sudden onset of neurological symptoms in the background of a thrombotic milieu prompted us to do further neurological evaluation which revealed extensive cerebral venous sinus thrombosis. She received anticoagulation without delay. Although the condition is associated with high mortality our patient showed very good response to anticoagulation and she was discharged in a stable condition.
