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Parenchymal abnormalities associated with developmental venous anomalies.

Diego San Millán Ruíz1, Jacqueline Delavelle, Hasan Yilmaz

  • 1Division of Interventional Neuroradiology, Johns Hopkins Hospital, 600 N. Wolfe Street, Baltimore, MD 21287, USA. dsanmil1@jhmi.edu

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Cerebral developmental venous anomalies (DVAs) are frequently associated with brain parenchymal abnormalities, occurring in nearly two-thirds of cases. These changes, including atrophy and white matter lesions, likely result from chronic venous hypertension secondary to DVA outflow obstruction.

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Area of Science:

  • Neurology
  • Radiology
  • Vascular Malformations

Background:

  • Retrospective analysis of 84 cerebral developmental venous anomalies (DVAs).
  • Focus on associated parenchymal abnormalities within the DVA drainage territory.

Purpose of the Study:

  • To investigate the prevalence and nature of parenchymal abnormalities associated with DVAs.
  • To understand the relationship between DVAs and secondary brain changes.

Main Methods:

  • DVAs identified via MRI and CT scans.
  • Assessment for parenchymal changes: atrophy, white matter lesions, calcifications, hemorrhage, cavernous-like vascular malformations (CVMs).
  • Evaluation for collecting vein stenosis.

Main Results:

  • Brain abnormalities found in 65.4% of cases.
  • Common findings include atrophy (29.7%) and white matter lesions (28.3% on MRI, 19.3% on CT).
  • CVMs (13.3%), calcifications (9.6%), hemorrhage (2.4%), and vein stenosis (13.1%) were also noted.

Conclusions:

  • Nearly two-thirds of DVAs are associated with brain parenchymal abnormalities.
  • These abnormalities are likely secondary to chronic venous hypertension, possibly developing post-natally.
  • Outflow obstruction and DVA wall changes contribute to venous hypertension.