Basal Vein of Rosenthal Variants: A Susceptibility Factor for Perimesencephalic Non-Aneurysmal Subarachnoid…

StudyAJNR. American journal of neuroradiology· Aug 2026

Basal Vein of Rosenthal Variants: A Susceptibility Factor for Perimesencephalic Non-Aneurysmal Subarachnoid Hemorrhage but not a Predictor of Severity.

Christoph Ziegenfuß, Natalie van Landeghem, Rosa Schubert … Yan Li

CerebrovascularStudyQ1IF 3.1

Primitive basal vein of Rosenthal drainage more frequent in perimesencephalic non-aneurysmal subarachnoid hemorrhage

Basal Vein of Rosenthal Variants: A Susceptibility Factor for Perimesencephalic Non-Aneurysmal Subarachnoid Hemorrhage but not a Predictor of Severity.

Christoph Ziegenfuß … Yan Li

AJNR. American journal of neuroradiology · Aug 2026 · Q1 in Neurology

Purpose

Variants of basal vein of Rosenthal (basal vein of Rosenthal), particularly the primitive drainage pattern, have been associated with the occurrence of perimesencephalic non-aneurysmal subarachnoid hemorrhage (PMNSAH).

Methods

This retrospective single-center study included 78 consecutive PMNSAH patients from 2002 to 2025 and 78 propensity-score-matched angiographic control patients selected from a pool of 117 controls.

n = 117 controls

Results

primitive basal vein of Rosenthal drainage was nearly twice as common in perimesencephalic hemorrhage as in matched controls

OR by subgroup · 95% CI

More results

Basal vein of Rosenthal drainage patterns differed between PMNSAH and propensity-score-matched controls, most pronounced for BVR_max (p=0.006).

More results

Increasing age was independently associated with higher modified Fisher grade (OR 1.06; 95% CI, 1.01-1.10; p=0.02), higher PM-mHSS total (OR 1.06; 95% CI, 1.02-1.11; p=0.004), and worse discharge mRS (OR 1.06; 95% CI, 1.00-1.11; p=0.04).

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Conclusion · 1 of 2

Primitive basal vein of Rosenthal drainage is more frequent in PMNSAH than in propensity-score-matched angiographic controls, supporting a venous contribution to PMNSAH susceptibility.

Conclusion · 2 of 2

basal vein of Rosenthal variants have less relevance on initial hemorrhage burden or neurological sequela from admission to discharge.

Basal Vein of Rosenthal Variants: A Susceptibility Factor for Perimesencephalic Non-Aneurysmal Subarachnoid Hemorrhage but not a Predictor of Severity.

Basal Vein of Rosenthal Variants: A Susceptibility Factor for Perimesencephalic Non-Aneurysmal Subarachnoid Hemorrhage but not a Predictor of Severity.

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