Basal vein of Rosenthal anomaly with aplasia of the telencephalic segment and prominent lateral mesencephalic vein.

Abstract

Purpose: The Basal Vein of Rosenthal (BVR) is one of the most stable intracranial veins. Despite this, several anomalies have been described and are related to its embryological origin as a longitudinal vein generated by the anastomosis between different segments. The anatomical variability also accounts for the presence and activation of different functional drainage pathways, both anteriorly and posteriorly, as well as with anastomoses with the infratentorial venous system METHODS: We are presenting an incidental finding in a patient undergoing brain Magnetic Resonance Imaging (MRI) in the diagnostic work-up of endolymphatic hydrops. The left BVR was the main location of anomalies including the hypoplasia of the first (telencephalic) segment, ad its afferents, and the presence of an additional drainage via the lateral mesencephalic vein (LMV) to the cavernous sinus and the transverse-sygmoid sinus (via a persistent oblique occipital sinus) besides the Galenic system.

Conclusions: Although being stable, several anomalies of the BVR have been described, and the present case adds to the previous reports a combination of anomalies with hypoplasia of the first segment, prominent LMV and the drainage though a persistent oblique occipital sinus.