Drainage of the basal vein of Rosenthal into the confluence of sinuses / 대한해부학회지

An adult female was found to have a variation of the left basal vein of Rosenthal after presenting with complaints of headache. The vein, in this case, drained directly into the confluence of sinuses instead of the great vein of Galen. Variation of the basal vein is likely due to the embryonic development of the deep cerebral venous system as primitive structures either differentiate further or regress with age. Such changes may result in the uncommon presentation seen in this case. To our knowledge, this is the first case reported of the basal vein draining into the confluence of sinuses.

A Unique Type of Dural Arteriovenous Fistula at Confluence of Sinuses Treated with Endovascular Embolization: A Case Report / 신경중재치료의학

Dural arteriovenous fistula (DAVF) is classically defined as abnormal arteriovenous connections located within the dural leaflets. Though the exact etiology is still not clear, they are generally accepted as acquired lesions. However, some DAVFs formed as the congenital disorders are called dural arteriovenous malformations and these lesions with a marked cortical venous reflux are considered to be aggressive and warrant an early intervention. The authors describe a case of 35-year-old man presented with unique type of DAVF. The fistula was located adjacent to the confluence of venous sinuses with multiple feeders. The feeders drained into a large venous pouch just anterior to the confluence which had a bilateral venous drainage. This was associated with multiple cerebellar venous ectasia along the draining cortical vein. It was managed by staged endovascular procedures and complete cure could be achieved. The pathogenesis and technique of embolization of this complex fistula/malformation are also discussed.