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Cavernous Malformation Associated With Arterialized Developmental Venous Anomaly: A Case Report.
Kenta Nakase1, Yasushi Motoyama1, Tokiko Nakai2
1Department of Neurosurgery, Nara Medical University, Kashihara, Nara, Japan.
Neurosurgery
|April 13, 2017
Summary
This study reports the first case of cavernous malformations (CMs) associated with an arterialized developmental venous anomaly (DVA). This finding suggests arterial bleeding from the DVA may contribute to CM formation.
Area of Science:
- Neurology
- Vascular Malformations
- Neuroimaging
Background:
- Developmental venous anomalies (DVAs) are common vascular malformations.
- Cavernous malformations (CMs) are also recognized cerebrovascular lesions.
- The association between DVAs and CMs is debated, with hemodynamic stress from venous outflow restriction being a proposed mechanism.
Observation:
- A rare case of an arterialized DVA in the brainstem presenting with recurrent cerebellar hemorrhage is described.
- Histological examination of the surgical specimen from the hematoma cavity revealed the presence of CMs.
Findings:
- This case represents the first documented instance of CMs occurring in conjunction with an arterialized DVA.
- The presence of an arterial component within the DVA, in addition to venous congestion, is implicated.
Implications:
- The findings suggest that bleeding from the arterial component of an arterialized DVA could be a novel mechanism for CM formation.
- This challenges existing hypotheses solely based on venous outflow obstruction.
- Further research into the pathogenesis of CMs associated with complex vascular malformations is warranted.