Developmental venous anomalies and cerebral cavernous malformations: Partners in crime

Developmental venous anomalies (DVAs) are benign congenital veins that collect normal brain drainage into a single outlet. Cerebral cavernous malformations (CMs) are clusters of thin-walled capillary cavities prone to bleeding. When both lesions coexist, the DVA's altered venous pressure and flow can promote CM formation or rupture. Detecting a DVA abutting an otherwise unexplained intracerebral hemorrhage can therefore raise suspicion of an occult CM as a likely cause, a clue which may be invaluable for daily clinical practice. The main focus of this review is to acknowledge the hallmark imaging appearances of DVAs and CMs, as well as their coexistence, explore the clinical consequences of mixed lesions, and emphasize that recognizing their partnership is vital for an accurate, timely diagnosis and appropriately targeted management.