Thrombosis of a Developmental Venous Anomaly Causing Venous Infarction and Pontine Hemorrhage

Griffiths, Dayna; Newey, Allison; Faulder, Kenneth; Steinfort, Brendan; Krause, Martín

doi:10.1016/j.jstrokecerebrovasdis.2013.04.033

Cited by 18 publications

(15 citation statements)

References 13 publications

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“…The clinical sequelae of DVA are likely related to the regional changes that occur near it. [42] They reported histopathologic evidence of vascular remodeling related to altered hemodynamics in the region of DVA, including microvascular wall hyalinization and calcification, which are consistent with chronic regional blood flow alternation and venous hypertension. [43] Very few cases have been reported in which DVAs were located in the same area as the EEG focus of the seizure.…”

Section: Discussionmentioning

confidence: 91%

New Trends in Management of Epilepsy in Patients with Cerebral Venous Malformations: Our Experience

Artyukhov¹,

Дмитренко²,

Shnayder³

et al. 2016

Int J Biomed

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Background: Venous vascular malformations, also known as venous angiomas or, more exactly, developmental venous anomalies (DVAs), represent congenital, anatomically variant pathways in the normal venous drainage of the brain area. In general neurological practice, DVAs are not considered epileptogenic, therefore, in conducting neuroimaging as a rule, not taken into account. A positive correlation, however, between the location of DVAs and the electroencephalographic seizure focus is debated. Materials and Methods:The present study provides a complete analysis of clinical and MRI characteristics of symptomatic epilepsies associated with cerebral venous malformations in children and adults. Patients were selected after a retrospective search through the database of the University Clinic into which, since 2016, patients were prospectively entered. To date (February 2016), there is a total of 5,856 patients with epilepsy of which there are 105 patients with congenital malformations of the brain, and 32 of them were found to have principal diagnosis of DVA.Results: Cavernous angiomas prevailed among venous anomalies (53.1%); DVAs were registered in 46.9% of cases. The associated analysis of DVA localization and the epileptic seizure types showed a direct relationship in 60.0% cases.Conclusion: DVAs as a cause of seizures are important to consider when examining patients with epileptic seizures. (Int J Biomed. 2016;6(3):207-212.).

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Section: Discussionmentioning

confidence: 91%

New Trends in Management of Epilepsy in Patients with Cerebral Venous Malformations: Our Experience

Artyukhov¹,

Дмитренко²,

Shnayder³

et al. 2016

Int J Biomed

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“…Drainage vein thrombosis of a DVA is rare, and only 28 patients with 29 cases of symptomatic thrombosed DVAs have been reported in the literature [1,2,3,4,5,6,7,8,9,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28]. These patients had a variety of presentations including venous ischemic infarction (n = 16, 55%), parenchymal hemorrhage (n = 8, 28%), venous congestive edema (n = 3, 10%), or subarachnoid hemorrhage (n = 2, 7%).…”

Section: Discussionmentioning

confidence: 99%

Symptomatic Infratentorial Thrombosed Developmental Venous Anomaly: Case Report and Review of the Literature

Amuluru¹,

Al‐Mufti²,

Stephen³

et al. 2015

Intervent Neurol

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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.

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“…Because DVAs serve as the venous outflow for a certain territory of brain tissue, disruption can be catastrophic, whether by spontaneous thrombosis or iatrogenically [16,23]. Of the cases of TN caused by a DVA with sufficient treatment descriptions in the literature, 5 were treated conservatively, 1 underwent glycerol rhizotomy and 10 underwent MVD [2,15].…”

Section: Discussionmentioning

confidence: 99%

Gamma Knife Stereotactic Radiosurgery for Trigeminal Neuralgia Caused by a Developmental Venous Anomaly

Harrison

Lunsford²,

Monaco³

2015

Stereotact Funct Neurosurg

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Background: Trigeminal neuralgia (TN) is mostly caused by vascular compression of the nerve's root entry zone due to an ectatic artery. Rarer causes include compression from tumors, vascular malformations or multiple sclerosis plaques. Developmental venous anomalies (DVAs) are benign, aberrantly appearing venous structures that drain normal cerebral tissue. DVAs are a rare etiology of TN. The management of TN caused by a DVA is controversial as disruption of the DVA can be catastrophic. Methods: We report a case of a young man with severe medically refractory TN related to a brachium pontis DVA who was successfully treated by gamma knife stereotactic radiosurgery (GKSR) to the trigeminal nerve. Results: Within 2 weeks of GKSR, the patient reported experiencing 60% pain relief; 5 years postoperatively, he remains completely pain free with some mild sensory loss in the V2 and V3 areas. Conclusions: GKSR has an established role in the management of TN. This is the first reported case of using GKSR to treat TN caused by a DVA. In the setting of a DVA, GKSR should be an initial consideration for TN therapy after medical failure because of the high surgical risk related to disrupting the DVA.

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Thrombosis of a Developmental Venous Anomaly Causing Venous Infarction and Pontine Hemorrhage

Cited by 18 publications

References 13 publications

New Trends in Management of Epilepsy in Patients with Cerebral Venous Malformations: Our Experience

New Trends in Management of Epilepsy in Patients with Cerebral Venous Malformations: Our Experience

Symptomatic Infratentorial Thrombosed Developmental Venous Anomaly: Case Report and Review of the Literature

Gamma Knife Stereotactic Radiosurgery for Trigeminal Neuralgia Caused by a Developmental Venous Anomaly

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