Appearance of venous malformations on magnetic resonance imaging

Rigamonti, Daniele; Rf, Spetzler; Drayer, B P; Wm, Bojanowski; Hodak, J A; Kh, Rigamonti; Plenge, Kathern L.; Powers, Maureen A.; Rekate, Harold L.

doi:10.3171/jns.1988.69.4.0535

Cited by 66 publications

(14 citation statements)

References 28 publications

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“…The radiological appearance of DVAs is well established 18, 26, 27. CT and MRI now permit diagnosing DVAs with confidence in the absence of digital subtraction angiography (DSA).…”

Section: Imaging Of Dvasmentioning

confidence: 99%

Cerebral developmental venous anomalies: Current concepts

Ruíz¹,

Yılmaz²,

Gailloud³

2009

Annals of Neurology

203

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Cerebral developmental venous anomalies are the most frequently encountered cerebral vascular malformation, and as such, are frequently reported as fortuitous findings in computed tomography (CT) and magnetic resonance imaging (MRI) studies. Developmental venous anomalies (DVAs) are generally considered extreme anatomical variations of the cerebral vasculature, and follow a benign clinical course in the vast majority of cases. Here we review current concepts on DVAs with the aim of helping clinicians understand this complex entity. Morphological characteristics that are necessary to conceptualize DVAs are discussed in depth. Images modalities used in diagnosing DVAs are reviewed, including new MRI or CT techniques. Clinical presentation, association with other vascular malformations and cerebral parenchymal abnormalities, and possible physiopathological processes leading to associated imaging or clinical findings are discussed. Atypical forms of DVAs are also reviewed and their clinical significance discussed. Finally, recommendations as to how to manage asymptomatic or symptomatic patients with a DVA are advanced.

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“…The radiological appearance of DVAs is well established 18, 26, 27. CT and MRI now permit diagnosing DVAs with confidence in the absence of digital subtraction angiography (DSA).…”

Section: Imaging Of Dvasmentioning

confidence: 99%

Cerebral developmental venous anomalies: Current concepts

Ruíz¹,

Yılmaz²,

Gailloud³

2009

Annals of Neurology

203

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“…In general, DVAs either simple, such as the venous angioma, or complex are rarely, if ever, associated with hemorrhage, unlike entities such as cavernous venous malformations or AVMs. 2,6,8,9 Cavernous venous malformations associated with venous variants likely represent the true cause of hemorrhage. 2 It is important to recognize that this pattern of venous enlargement and drainage represents a venous anomaly, not a malformation.…”

Section: Discussionmentioning

confidence: 99%

Complex right hemisphere developmental venous anomaly associated with multiple facial hemangiomas

Aagaard¹,

Song²,

Eskridge³

et al. 1999

Journal of Neurosurgery

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Complex developmental venous anomalies (DVAs) represent variations of normal cerebral venous drainage and consist of dilation of the superficial and/or deep venous system. These rare anomalies can occur unilaterally or bilaterally, supratentorially or infratentorially, focally or they can affect the entire hemisphere. Some DVAs are associated with cervicofacial venous malformations or facial lymphatic malformations. Anomalies of this type are generally clinically silent, and cerebral dysfunction is usually absent. Symptoms, when they occur, are most commonly headache or mild seizure disorders. The angiographic findings are striking, with well-formed but enlarged transcerebral medullary and deep and/or superficial cortical veins. Opacification of these venous structures occurs within the same time frame as a normal angiographic venous phase. The authors report the case of a 33-year-old man in whom a large inoperable arteriovenous malformation had been previously diagnosed and who presented with seizures. Repeated magnetic resonance imaging and angiography demonstrated abnormally dilated transcerebral, superficial, and deep venous structures involving the entire right hemisphere with no identifiable nidus. Additionally, multiple bilateral benign facial hemangiomas were present in this patient. It is important to recognize this rare venous appearance as a developmental variant and not mistake it for an arteriovenous malformation or a partially thrombosed vein of Galen malformation. Because these venous anomalies are extreme variants of the normal venous system, hemorrhage rarely, if ever, occurs and the patient can be reassured that no interventional or surgical therapy is necessary or warranted.

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“…2 Other authors have found evidence of CMs in the presence of DVAs, and have suggested that occult CMs may play a large role in DVA hemorrhage. 15 Other studies, however, have examined ruptured DVAs histologically, and found no evidence of associated CMs. 23 Rarely, venous aneurysms have been reported as a potential source of bleeding.…”

Section: Discussionmentioning

confidence: 99%

Endovascular occlusion of a ruptured transitional aneurysm associated with a developmental venous anomaly

Ducruet¹,

Kellner²,

Connolly³

et al. 2009

FOC

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Developmental venous anomalies (DVAs) represent a rare cause of intraparenchymal hemorrhage. This case demonstrates an unusual DVA associated with venous hypertension, arteriovenous shunting, and a ruptured transitional aneurysm. The authors describe the first use of embolization as a treatment method for an unstable ruptured transitional aneurysm associated with a DVA. This 33-year-old man suffered acute onset of headache, gait ataxia, and left hemiparesis. Computed tomography brain scans demonstrated a deep paramedian right frontal intraparenchymal hemorrhage. No cavernous malformation was apparent on MR imaging. Diagnostic angiography revealed arteriovenous shunting from the right anterior and middle cerebral arteries to a large DVA with an associated arteriovenous fistula, with a 3-mm aneurysm in the transition from pericallosal artery to the collecting vein. Both surgical and endovascular treatment options were considered. The patient underwent repeat angiography on hospital Day 7, at which time the aneurysm had increased to 5 mm, and endovascular treatment was selected. Acrylic occlusion of the aneurysm was performed and confirmed angiographically. The patient's neurological symptoms resolved throughout the hospital stay, and he remains symptom free in the 10 months since treatment. Developmental venous anomalies are not usually associated with arteriovenous shunting and aneurysms as a source of intraparenchymal hemorrhage. Endovascular occlusion of the aneurysm without blockage of physiologically necessary venous structures is a possible method of treatment for this complex mixed vascular lesion, and has proven safe and effective in this patient. To the authors' knowledge, this is the first presentation of this situation in the literature.

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Appearance of venous malformations on magnetic resonance imaging

Cited by 66 publications

References 28 publications

Cerebral developmental venous anomalies: Current concepts

Cerebral developmental venous anomalies: Current concepts

Complex right hemisphere developmental venous anomaly associated with multiple facial hemangiomas

Endovascular occlusion of a ruptured transitional aneurysm associated with a developmental venous anomaly

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