Isolated hemorrhagic arterialized DVAs: revisiting symptomatic DVAs

Ahmed, Manzoor; Almarzooqi, Mohamed-Karji; Younes, Basel; Alokaili, Riyadh; Azam, Farooq

doi:10.1007/s10072-020-04294-9

Cited by 3 publications

(2 citation statements)

References 42 publications

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“…Alternatively, a scaffold of neoangiogenesis compounded by diffuse microshunts in consensus with Pereira et al 15 hypothesis. However, we also propose the limitations of this theory, which does not partially expound the appearance of a spectrum of arterialized DVAs that demonstrate no feeding arteries, but instead demonstrate late arterial filling of the collector vein without the medusa of the DVA, as described by Ahmed et al 35 Furthermore, the remarkable elevation in cerebral blood flow in case 2 was an MRI corollary of AV shunting. Preliminary studies exploring the perfusion characteristics of asymptomatic DVAs proposed that perfusion abnormalities brought about in native nonpathological DVAs were more pronounced in gradient echo-based T2* perfusion-weighted imaging.…”

Section: Discussionmentioning

confidence: 63%

“…However, the postulated neoangiogenesis cannot account for the exuberant capillary staining, as illustrated in our cases. Alternatively, a scaffold of neoangiogenesis compounded by diffuse microshunts in consensus with Pereira et al 15 and Ahmed et al 35 is a feasible hypothesis. However, we also propose the limitations of this theory, which does not partially expound the appearance of a spectrum of arterialized DVAs that demonstrate no feeding arteries, but instead demonstrate late arterial filling of the collector vein without the medusa of the DVA, as described by Ahmed et al 35 …”

Section: Discussionmentioning

confidence: 93%

See 1 more Smart Citation

An Illustrative Review of the Pathomechanisms of Symptomatic Developmental Venous Anomalies

Ahmed¹,

Saini²,

Gorantla³

et al. 2023

J Comput Assist Tomogr

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Objective Symptomatic developmental venous anomalies (DVAs) are rare. Here, we illustrate the varied clinicoradiologic profiles of symptomatic DVAs and contemplate the mechanisms that render these (allegedly) benign entities symptomatic supported by a review of literature. Methods Institutional databases were searched to identify cases of symptomatic DVAs. Clinical and imaging (angiographic and cross-sectional) data of 9 cases with 11 neurovascular symptoms consequent to inflow/outflow perturbations and mechanical obstruction that manifested because of the strategic topography of underlying DVAs were analyzed. A review of the existing literature on DVAs in agreement with our case series was performed on publications retrieved from the PubMed database. Results Symptoms secondary to venous hypertension arising from flow-related perturbations were broadly divided into those arising from restricted outflow and increased inflow. Restricted outflow occurred because of collector vein stenosis (n = 2) and collector vein/DVA thrombosis (n = 3), whereas the latter pathomechanism was initiated by arterialized/transitional DVAs (n = 2). A mechanical/obstructive pathomechanism culminating in moderate supratentorial ventriculomegaly was noted in 1 case. One patient was given a diagnosis of hemorrhage associated with a cavernoma. Conclusions Awareness and contextualization of potential flow-related perturbations and mechanical insults that render DVAs symptomatic aid in accurate diagnosis, management, and prognostication.

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Section: Discussionmentioning

confidence: 63%