The Many Faces of Cerebral Developmental Venous Anomaly and Its Mimicks: Spectrum of Imaging Findings

Nabavizadeh, Seyed Ali; Mamourian, Alexander C.; Vossough, Arastoo; Loevner, Laurie A.; Hurst, Robert W.

doi:10.1111/jon.12373

Cited by 14 publications

(5 citation statements)

References 46 publications

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“…DVAs draining gray matter were significantly more likely to be hypometabolic than those draining only white matter. These findings support the theory that DVAs produce focal hemodynamic alterations that can result in diminished venous drainage and decrease metabolism in the drainage territory 135–137 . These regional hypometabolism should not be mistaken for a seizure network (Fig 18).…”

Section: Vascularsupporting

confidence: 80%

“…Evaluation of DVAs using dynamic susceptibility contrast MR perfusion studies has demonstrated elevation in cerebral blood volume, cerebral blood flow, and delayed time to peak and mean transit time in the brain parenchyma near the DVAs as compared with contralateral parenchyma 134 . These perfusion profiles suggest slow flow, and perhaps increase in perfusion pressure in the region drained by DVA 135 . Moreover, PET scan in the parenchymal adjacent to DVA commonly corresponds to glucose hypometabolism 136,137 .…”

Section: Vascularmentioning

confidence: 99%

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Anatomical Variations, Mimics, and Pitfalls in Imaging of Patients with Epilepsy

Hassankhani

Stein

Haboosheh³

et al. 2020

Journal of Neuroimaging

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Epilepsy is among one of the most common neurologic disorders. The role of magnetic resonance imaging (MRI) in the diagnosis and management of patients with epilepsy is well established, and most patients with epilepsy are likely to undergo at least one or more MRI examinations in the course of their disease. Recent advances in high‐field MRI have enabled high resolution in vivo visualization of small and intricate anatomic structures that are of great importance in the assessment of seizure disorders. Familiarity with normal anatomic variations is essential in the accurate diagnosis and image interpretation, as these variations may be mistaken for epileptogenic foci, leading to unnecessary follow‐up imaging, or worse, unnecessary treatment. After a brief overview of normal imaging anatomy of the mesial temporal lobe, this article will review a few important common and uncommon anatomic variations, mimics, and pitfalls that may be encountered in the imaging evaluation of patients with epilepsy.

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Section: Vascularsupporting

confidence: 80%

Section: Vascularmentioning

confidence: 99%

Anatomical Variations, Mimics, and Pitfalls in Imaging of Patients with Epilepsy

Hassankhani

Stein

Haboosheh³

et al. 2020

Journal of Neuroimaging

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“…Arteriovenous malformations – clusters of abnormal arteries and veins with an increased risk of intracranial bleed, more common in young adults [4]. DVAs – most commonly encountered malformation involving the intracranial venous system, which are also known as venous angioma, cerebral venous medullary malformation, or cerebral venous malformation [5]. CCM – vascular spaces of varying sizes, lined by a single layer of endothelin with no distinct features of arteries or veins [6].…”

Section: Intracranial Vascular Malformationsmentioning

confidence: 99%

Cerebral Cavernous Malformations, Developmental Venous Anomaly, and Its Coexistence: A Review

et al. 2020

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Background: Cerebral cavernous malformations (CCMs) are intracranial vascular malformations that can exist as a single lesion or mixed vascular lesions. The most common mixed form is the coexistence of CCM with an associated developmental venous anomaly (DVA). In this paper, we aim to give a comprehensive review of CCM, DVA, and their coexistence as mixed lesions. A PubMed search using the keywords “Cerebral cavernous malformations, Developmental venous anomaly, Mixed Cerebral cavernous malformations with Developmental venous anomaly” was done. All studies in the English language in the past 10 years were analyzed descriptively for this review. Summary: The search yielded 1,249 results for “Cerebral cavernous malformations,” 271 results for “Developmental venous anomaly,” and 5 results for “Mixed Cerebral cavernous malformations with Developmental venous anomaly.” DVA is the most common intracranial vascular malformation, followed by CCM. CCM can have a wide array of clinical presentations like hemorrhage, seizures, or focal neurological deficits or can also be an incidental finding on brain imaging. DVAs are benign lesions by nature; however, venous infarction can occur in a few patients due to acute thrombosis. Mixed CCM with DVA has a higher risk of hemorrhage. CCMs are angiographically occult lesion, and cerebral digital subtraction angiography is the gold standard for the diagnosis of DVA. Mixed lesions, on the other hand, are best diagnosed with magnetic resonance imaging, which has also been effective in detecting specific abnormalities. Asymptomatic lesions are treated through a conservative approach, while clinically symptomatic lesions need surgical management. Conclusion: Individual CCM or DVA lesions have a benign course; however, when they coexist in the same individual, the hemorrhagic risk is increased, which prompts for rapid diagnosis and treatment.

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“…In this scenario, hemosiderin and calcium can be detected. DVAs usually show on MRI flow voids but sometimes only are demonstrated on postcontrast T1‐weighted images, or using SWI, frequently located in the frontal lobes or posterior fossa, often in the vicinity of the ventricular system 27 (Figure 5).…”

Section: Brain Vm Taxonomymentioning

confidence: 99%

Conventional and advanced MRI evaluation of brain vascular malformations

Martín-Noguerol

Concepción-Aramendía

Lim

et al. 2021

Journal of Neuroimaging

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Vascular malformations (VMs) of the central nervous system (CNS) include a wide range of pathological conditions related to intra and extracranial vessel abnormalities. Although some VMs show typical neuroimaging features, other VMs share and overlap pathological and neuroimaging features that hinder an accurate differentiation between them. Hence, it is not uncommon to misclassify different types of VMs under the general heading of arteriovenous malformations. Thorough knowledge of the imaging findings of each type of VM is mandatory to avoid these inaccuracies. Conventional MRI sequences, including MR angiography, have allowed the evaluation of CNS VMs without using ionizing radiation. Newer MRI techniques, such as susceptibility‐weighted imaging, black blood sequences, arterial spin labeling, and 4D flow imaging, have an added value of providing physiopathological data in real time regarding the hemodynamics of VMs. Beyond MR images, new insights using 3D printed models are being incorporated as part of the armamentarium for a noninvasive evaluation of VMs. In this paper, we briefly review the pathophysiology of CNS VMs, focusing on the MRI findings that may be helpful to differentiate them. We discuss the role of each conventional and advanced MRI sequence for VMs assessment and provide some insights about the value of structured reports of 3D printing to evaluate VMs.

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The Many Faces of Cerebral Developmental Venous Anomaly and Its Mimicks: Spectrum of Imaging Findings

Cited by 14 publications

References 46 publications

Anatomical Variations, Mimics, and Pitfalls in Imaging of Patients with Epilepsy

Anatomical Variations, Mimics, and Pitfalls in Imaging of Patients with Epilepsy

Cerebral Cavernous Malformations, Developmental Venous Anomaly, and Its Coexistence: A Review

Conventional and advanced MRI evaluation of brain vascular malformations

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