Management of Symptomatic Hemorrhage From a Developmental Venous Anomaly

Area of Science:

• Neurology
• Vascular Surgery
• Neurosurgery

Background:

• Developmental venous anomalies (DVAs) are common, benign vascular malformations in the brain.
• DVAs typically have low blood flow and rarely cause symptoms independently.
• Hemorrhage from DVAs is exceedingly rare, usually occurring only when associated with cerebral cavernous malformations.

Observation:

• A case of a large, symptomatic intracranial hemorrhage originating from an isolated DVA is presented.
• The patient experienced significant neurological symptoms due to the hemorrhage.
• Standard contraindications for DVA resection include high risk of venous infarction.

Findings:

• Surgical evacuation of the hematoma was performed.
• The specific portion of the isolated DVA responsible for the hemorrhage was carefully resected.
• This intervention successfully managed the symptomatic hemorrhage.

Implications:

• This case challenges the established view that resection of isolated DVAs is always contraindicated.
• Careful surgical resection can be a viable treatment option for rare cases of hemorrhagic isolated DVAs.
• Further consideration of surgical intervention may be warranted in select patients with symptomatic DVA hemorrhages.