A Rare Variant of Caval Malformation: Left-Dominant Caval System With Anomalous Cardiac Drainage

In aggregate, caval malformations are relatively common congenital abnormalities that exist on a spectrum of severity and rarity. These result from inappropriate persistence or regression of bilateral primitive caval structures. Here, we present the case of a 44-year-old woman with a complex cardiovascular medical history who presented for a fall with bilateral subdural hematomas. During workup, she was found to have an extremely rare variant of caval malformation, including both left-sided inferior vena cava (IVC) with hemiazygos continuation and left-sided superior vena cava (SVC). This case serves as an opportunity to learn about the embryology and pathology associated with caval malformations. Ultimately, these anomalies were determined not to be implicated in her fall or the treatment of subdural hematomas but raise questions when considering the treatment of her cardiovascular comorbidities.