Purpose: Foramen of Vesalius (FV) is a small, variable and frequently symmetrical structure located in the greater wing of the sphenoid bone, and anteromedial to the foramen ovale (FO). It transmits an emissary vein through which the cavernous sinus and pterygoid plexus communicate. Our aim was to study the morphological and morphometric variations of FV on CT angiography (CTA) of brain. There have been only few imaging studies evaluating this foramen. Some claim that an asymmetric FV is likely the result of a pathologic process than a normal variant. This is not consistent with our clinical experience and wanted to investigate the incidence of asymmetry with associated skull base pathologies.
Materials and Methods: We retrospectively studied one hundred consecutive CTA of the brain for variations in size, shape, presence or absence and any duplication of the FV, surface area, distance from FO, and any associated skull base pathology. After collecting data, statistical analysis was done
Results: FV was present in 56 of the total studies, 36% asymmetric (unilateral), and was assimilated in FO in 64% of the cases. There was no associated skull base pathology with asymmetry. There was no signicant difference between the unilateral FV on the right or left sides of the skulls. Although based on our results left sided was slightly higher, which is consistent with other prior studies.
Conclusions: FV is an inconsistent foramen of sphenoid bone, but we found no association between the incidence of asymmetry or large FV with any skull base pathologies. The morphological and morphometric variations of FV on CTA of the brain are important to the clinicians in diagnosis and management of various conditions where micro-neurosurgical and microvascular approach is a needed.
