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Intracerebral hemorrhage due to developmental venous anomalies

Xiaodi Li1, Yuzhou Wang1, Wenming Chen1

  • 1Department of Neurology, Guangdong 999 Brain Hospital, Shatai Road 578, 510510 Guangzhou, China.

Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia
|January 25, 2016
PubMed

Insights

Developmental venous anomalies (DVA) and cavernous malformations (CM) can cause brain bleeds. Hemorrhagic DVA often occur in the cerebellum and have milder symptoms than CM, suggesting DVA as a likely cause of cerebellar hemorrhage.

Area of Science:

  • Neurology
  • Neurosurgery
  • Radiology

Background:

  • Developmental venous anomalies (DVA) and cavernous malformations (CM) are common cerebral vascular malformations.
  • Distinguishing between DVA and CM is crucial, especially when they cause intracerebral hemorrhage (ICH).

Purpose of the Study:

  • To compare the demographic, clinical, and radiological features of ICH caused by DVA versus CM.
  • To identify differentiating factors for hemorrhagic DVA and CM.

Main Methods:

  • Retrospective review of 1706 patients with acute spontaneous ICH between May 2008 and May 2013.
  • Identified 10 cases of DVA-induced ICH and 42 cases of CM-induced ICH.
  • Compared patient demographics, clinical presentation, neurological deficits, and radiological findings.

Main Results:

  • No significant differences in age or sex between DVA and CM groups.
  • DVA-induced ICH showed a predilection for the cerebellum (p=0.000) and less severe neurological deficits (p=0.008) compared to CM.
  • Hemorrhagic DVA were predominantly cerebellar, while hemorrhagic CM were mainly in the brainstem.

Conclusions:

  • Infratentorial hemorrhagic DVA are associated with cerebellar predominance and a generally benign clinical course.
  • Cerebellar hemorrhage, particularly in young adults, should raise suspicion for DVA over CM.
  • Understanding these differences aids in accurate diagnosis and management of vascular malformation-related hemorrhages.

Keywords:
Cavernous malformationDevelopmental venous anomalyIntracerebral hemorrhageMagnetic resonance imaging

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