Anatomical variations identified at the skull base can result in challenges to the clinician. For example, the anatomy of the foramen ovale and its neighboring structures is critical knowledge for the surgeon who performs transcutaneous approaches to the foramen ovale for treating patients with trigeminal neuralgia. One nearby structure that can compound invasive procedures and potentially result in complications is the foramen of Vesalius. Although usually small, we report a giant foramen of Vesalius found in an adult female skull. The anatomy and clinical aspects of such a finding are discussed and related to other reports in the literature.

A one-month-old female presented with irritability and failure to thrive. She was the product of a 35-week pregnancy and was delivered vaginally without complications or a difficult labor. Prenatal ultrasonography was not performed. Her