Cerebral transmantle vein on magnetic resonance imaging: an embryological pattern persisting up to the adulthood.

purposeThe intracranial venous system is characterized by a great variability both in anatomic and functional issues. In particular, the supratentorial venous system is distinguished in the adult configuration in a deep and superficial pathway. The communication between these two compartments is provided by the so-called transcerebral veins, tiny venous channels connecting the deep medullary veins with the superficial medullary veins. No further connection between the two systems has been described in the literature.

methodsWe are presenting an incidental finding in a patient undergoing brain Magnetic Resonance Imaging (MRI) in the diagnostic work-up of headache of migraine type. In fact, a hyperintense linear signal change in the white matter of the right hemisphere was identified, connecting the subependymal periventricular region with the pial surface and associated with a Susceptibility Weighted Imaging (SWI) appearance of a long venous channel continuing the course of the lateral thalamostriate vein. No further changes were identified and neuronal migration anomalies were absent.

conclusionsWe described a new type of connection between deep and superficial venous system, different from the transcerebral veins, and we called it transmantle vein, detailing anatomic and embryologic remarks.