Regional association of developmental venous anomalies with angiographically occult vascular malformations

This study reviews the neuroradiological findings of 43 patients with a developmental venous anomaly in order to discuss the clinical significance of this entity. All patients underwent unenhanced and contrast-enhanced computer tomography and magnetic resonance tomography, as well as selective angiography, and were followed for at least 2 years. In 40% (17 of 43) of patients a cryptic vascular malformation was found in the proximity to the developmental venous anomaly. Neurological symptoms were present in 8 of 17 patients (47%) in this group. Patients with an isolated developmental venous anomaly had symptoms in 19% (5 of 26), but none of them had experienced a hemorrhage. Magnetic resonance was the most sensitive method for the diagnosis of both types of lesions and alterations of the adjacent parenchyma. These results further support that developmental venous anomalies represent a clinically benign entity. However, patients with an association of a developmental venous anomaly and a cryptic vascular malformation are at risk for hemorrhage from their angiographically occult vascular malformation. Magnetic resonance proved to be the imaging modality of choice for both entities and is appropriate for diagnosis and follow-up.