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Complex right hemisphere developmental venous anomaly associated with multiple facial hemangiomas. Case report
B D Aagaard1, J K Song, J M Eskridge
1Department of Radiology, University of Washington, Seattle, USA.
Journal of Neurosurgery
|April 8, 1999
Summary
Complex developmental venous anomalies (DVAs) are rare variations in cerebral venous drainage. These benign conditions, often asymptomatic, should not be mistaken for more serious vascular malformations.
Area of Science:
- Neurology
- Radiology
- Vascular Malformations
Background:
- Developmental venous anomalies (DVAs) are variations of normal cerebral venous drainage.
- They involve dilation of superficial and/or deep cerebral venous systems, occurring focally or affecting entire hemispheres.
- DVAs can be associated with cervicofacial venous or lymphatic malformations.
Observation:
- A case of a 33-year-old man with a history of arteriovenous malformation and new-onset seizures is presented.
- Imaging revealed extensive, abnormally dilated transcerebral, superficial, and deep venous structures throughout the right hemisphere without a nidus.
- The patient also had multiple bilateral benign facial hemangiomas.
Findings:
- Angiography showed enlarged transcerebral medullary and cortical veins opacifying within the normal venous phase.
- The findings represented a complex DVA, a developmental variant, not an arteriovenous malformation or a partially thrombosed vein of Galen malformation.
- No identifiable nidus was present, distinguishing it from arteriovenous malformations.
Implications:
- It is crucial to differentiate complex DVAs from arteriovenous malformations to avoid unnecessary interventions.
- DVAs are generally clinically silent, with symptoms like headache or seizures being uncommon.
- As extreme variants of normal venous drainage, DVAs rarely hemorrhage, and patients typically require no interventional or surgical therapy.