An Adult Case of Absence Left Brachiocephalic Vein without an Intrathoracic Collateral Pathway

Abstract

We report an adult case of absence left brachiocephalic vein without a persistent left superior vena cava or accessory hemiazygos vein connection. A 64-year-old man was admitted to our hospital for tinnitis and diagnosed with cerebellar infarction. During admission, heart murmur was noted and aortic regurgitation was diagnosed. At aortic valve replacement, left brachiocephalic vein was not revealed in the usual position. Venography showed that venous blood from left upper limb was returned in a retrograde manner through the left internal jugular vein, passing through skull venous connection and draining to the right internal jugular vein. The patient did not experience edema of left upper limb. Moreover, the relationship between this venous return and the onset of cerebellar infarction was unclear.