Is there any relationship between the perimesencephalic subarachnoid hemorrhage and brainstem venous variations? A susceptibility-weighted imaging study.

OBJECTIVE

To investigate brainstem venous variations with susceptibility-weighted imaging (SWI) and its possible effect on the risk of perimesencephalic subarachnoid hemorrhage (pmSAH).

MATERIAL AND

METHODS

From 2018 to 2022, angiogram-negative spontaneous pmSAH patients and healthy volunteers who had neither a previous history of cerebral hemorrhage nor a known chronic disease were evaluated in the study. SWI was obtained from all individuals in the study group. In the imaging analysis; the diameter and anatomical course of brainstem veins, venous anastomoses, and draining veins were determined as venous variation criteria between the study groups.

RESULTS

Twenty patients and twenty age-matched healthy volunteers from whom SWI was obtained were included in the study. Median and lateral anterior pontomesencephalic veins, bilateral peduncular and pontomesencephalic sulcus veins, and anterior medullary veins were detected in all individuals. In addition, lateral medullary veins, transverse pontine veins, retro-olivary vein, and posterior communicating vein(s) could be detected ranging in 13% to 66% of cases in this study. There was no statistically significant difference between the mean diameter values of the brainstem veins in the study groups. The anatomical courses of these veins, venous anastomoses, and draining veins of the brainstem were similar both in the patient group and the control group.

CONCLUSION

In this SWI study, no significant relationship could be determined in brainstem venous anatomical variations indicating an increased risk of bleeding in patients with pmSAH.