Uncommon Cerebral Venous Sinus Variants in a Young Woman

A postpartum woman in her early 20s underwent MRI and MR venography for suspected pituitary apoplexy or venous sinus thrombosis, revealing an incidental Rathke cleft cyst, which possibly explained her symptoms, and two coexisting venous variants: a persistent falcine sinus with diminutive straight sinus and bilateral variant transverse sinuses. We discuss these uncommon anatomic variants and potential mimics of venous sinus thrombosis and then review the incidence of cerebral venous sinus variants, highlighting the importance of recognizing unusual venous anatomy during neuroimaging interpretation.