Primitive Basal Vein of Rosenthal Drainage More Common in PMNSAH, But Not Linked to Severity

Primitive basal vein of Rosenthal (BVR) drainage (type 3) was more frequent in PMNSAH than controls (47.4% vs 24.4%), but BVR variants did not predict hemorrhage severity or neurological outcome. Age was independently associated with worse outcomes.

• Primitive BVR drainage (type 3) was significantly more common in PMNSAH (47.4%) versus matched controls (24.4%, p=0.006 for BVR_max).
• By Bayesian ordinal regression, BVR variants showed no correlation with initial hemorrhage burden (PM-mHSS), admission neurological impairment, or discharge mRS.
• Age independently predicted worse outcomes: OR 1.06 for higher modified Fisher grade, PM-mHSS, and discharge mRS.

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