This article describes a case of prominent emissary veins of the hypoglossa
l canal protruding into the cerebellomedullary cistern mimicking disease, s
uch as a nerve sheath tumor. The diagnosis and differentiation in this inst
ance were confirmed by MR angiography and a review of alternative imaging p
lanes. A diagnosis of hypoglossal canal lesions should be made with caution
, as these lesions are quite rare, and vascular anomalies, such as those de
scribed, may mimic disease in this region.