Background: Developmental venous anomalies (DVAs) are variations of normal transmedullary veins draining white and gray matter. In the vast majority of cases, DVAs are diagnosed incidentally and should be considered as benign entities. In extremely rare circumstances, DVAs may become symptomatic due to mechanical or flow-related etiologies. Thrombosis of the collector vein of a DVA is a rare type of a flow-related complication with only 29 cases reported in the literature, the majority of which are supratentorial. Infratentorial thrombosed DVAs are thus extremely rare and the few cases reported have typically caused symptoms due to venous ischemic infarctions. Summary: We report a case of an infratentorial DVA with a thrombosed drainage vein in a patient with nonhemorrhagic, noninfarcted venous congestive edema, which was successfully treated with high-dose glucocorticoids and short-term anticoagulation. We review the pertinent venous anatomy of the posterior fossa as well as the literature of symptomatic infratentorial thrombosed DVAs. Key Message: The presented case of an infratentorial thrombosed DVA with cerebellar and pontine venous congestive edema is extremely rare. A working knowledge of posterior fossa venous anatomy and possible pathomechanisms responsible for the rarely symptomatic lesion will aid in the timely and efficacious treatment of such lesions.
Case Reportprevalence of 25-50% in stroke patients [4]. Its development is likely multifactorial, involving glenohumeral subluxation, impingement, rotator cuff tears, bicipital tendinitis, and CRPS [4]. Glenohumeral subluxation can occur as a result of weakness in the muscles that surround and provide stability to the shoulder joint. The joint is most vulnerable to subluxation in the period immediately after stroke, when muscle tone in the upper extremity is flaccid [6]. Subluxation itself can result in further complications, including CRPS and secondary brachial plexus injury.The estimated incidence of CRPS after stroke is between 2 and 49% [7,8]. CRPS is characterized by pain, edema, vasomotor abnormalities, and patchy demineralization of bone in an extremity, and is divided into two types based on the absence (Type I) or presence (Type II) of a definable nerve lesion. The majority of stroke patients with CRPS are diagnosed as Type I, however micro-trauma to nerves may in fact explain their are CPSP and Complex Regional Pain Syndrome (CRPS), and CPSP and shoulder pain [4].
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