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Unusual pattern of a deep developmental venous anomaly on CT and MR studies
N M Borden1, M H Khayata, B L Dean
1Division of Neuroradiology, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center 85013-4496, USA.
Objective:
This article focuses on an unusual cross-sectional imaging pattern of a deep developmental venous anomaly (DVA). Since these anomalies are nonpathologic, they must not be interpreted as a disease that requires further costly workup and potentially injurious procedures (cerebral angiography).
Materials And Methods:
Two women aged 19 (Case 1) and 30 (Case 2) years sought medical evaluation for severe headaches. Both patients underwent CT, MRI, and conventional cerebral angiography. Case 1 also underwent MR venography.
Results:
The diagnosis of an unusual DVA in Case 1 was confirmed only after conventional catheter angiography and a follow-up MR venogram. In Case 2 the diagnosis was inferred based upon the CT, MRI, and conventional angiography results and the marked similarity to Case 1. The presumptive diagnosis in Case 2 would not have been made with confidence without the prior experience of managing Case 1.
Conclusion:
DVAs (venous angiomas) are extreme variations in the pattern of intracranial venous drainage. These two case reports highlight an unusual pattern of this benign entity. Individuals interpreting cross-sectional imaging studies should be cognizant of this pattern.