Developmental venous anomaly (DVA) with arterial component: a rare cause of intracranial haemorrhage

Oran, İsmail; Kıroğlu, Yılmaz; Yurt, Alaattin; Ozer, F.; Acar, Feri̇dun; Dalbastı, Tayfun; Yagci, Baki; Şirikçi, Akif; Çallı, Cem

doi:10.1007/s00234-008-0456-9

Cited by 51 publications

(48 citation statements)

References 15 publications

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“…10,16 However, vp-AVMs showed histological features similar to AVMs, 6 and 2 cases of rebleeding have been reported previously. 8,15 We also experienced 1 case of a rebleeding episode among the patients who underwent conservative treatment. Accordingly, physicians should be aware of the possibility of hemorrhagic presentation in patients with vp-AVMs.…”

Section: Discussionmentioning

confidence: 99%

“…2,8,14,15 A general principle of GKS is to cover the extent of the staining area during the arterial phase without harming the main drainage vein to avoid possible venous infarction or hemorrhage. 13 Good treatment outcomes have been reported for venous anomalies, 1,11,13 but complete obliteration has not yet been reported in patients with vp-AVMs.…”

Section: Discussionmentioning

confidence: 99%

“…Radiation-induced complications are a concern after GKS. Oran et al 15 reported a case of fatal radionecrosis after GKS. Although no adverse events associated with GKS were observed in our case series, further study is required to better define the optimal parameters for the radiation dose, patient selection, and treatment strategy for radiation-resistant vp-AVM.…”

Section: Discussionmentioning

confidence: 99%

“…The number of patients in each study ranged from 3 to 15. The terminologies to describe a poorly defined arterial blush and an early venous drainage with a dilated medullary vein without a discrete nidus included mixed venous and arteriovenous malformation, 2 venous malformation with arterial fistulization, 14 venous angioma with AV shunt, 10 arterialized DVA, 15 and vp-AVM. Two rebleeding events were reported after conservative treatment.…”

Section: Review Of the Pertinent Literaturementioning

confidence: 99%

“…Two rebleeding events were reported after conservative treatment. 8,15 The time interval between the first and second bleeding ranged from 1 to 85 months. Fatal complications due to incomplete resection of the venous anomaly and radiation necrosis were reported.…”

Section: Review Of the Pertinent Literaturementioning

confidence: 99%

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Long-term treatment outcome of venous-predominant arteriovenous malformation

Jeon

Kim²,

Ahn

et al. 2016

JNS

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Beyond typical cerebrovascular malformations including arteriovenous malformations (AVMs), developmental venous anomalies (DVAs), cavernous malformations, and capillary telangiectasia, the disease concept and the proper treatment plan for some rare vascular lesions have not yet been well established. A poorly defined arterial blush and an early venous drainage with a dilated medullary vein from the arterial or capillary phase is one of the rare vascular anomalies. Such a vascular lesion can be distinguished from an AVM by the absence of a discrete nidus and poorly identifiable, enlarged feeding arteries, and distinguished from DVAs by the early venous drainage from the arterial or capillary phase. Various terminologies including arterialized DVA, 15 mixed-type vascular malformation, 6 venous angioma with arteriovenous (AV) shunt, 10 atypical DVA with early venous filling, mixed venous and arteriovenous malformations, medullary venous malformation with an arterial component, or venous-predominant AVM (vp-AVM), 8 which is referred to here, have been used to interpret the rare vascular anomalies, but still no definite terminology has been established.abbreviatioNs AV = arteriovenous; AVM = arteriovenous malformation; DVA = developmental venous anomaly; GKS = Gamma Knife surgery; ICH = intracranial hemorrhage; vp-AVM = venous-predominant AVM. obJective Treatment strategies for venous-predominant arteriovenous malformation (vp-AVM) remain unclear due to the limited number of cases and a lack of long-term outcomes. The purpose of this study was to report the authors' experience with treatment outcomes with a review of the pertinent literature in patients with vp-AVM. methods Medical and radiological data from 1998 to 2011 were retrospectively evaluated. The degree of the arteriovenous (AV) shunt was categorized into 2 groups, a high- and low-flow AV shunt based on the angiographic findings. results Sixteen patients with a mean age of 45.3 years (range 16-78 years) and a mean follow-up of 79.9 months (range 25-264 months) were examined. Symptomatic lesions were noted in 13 patients: intracranial hemorrhage (ICH) in 9, seizure in 1, and headache in 3. A high-flow shunt was observed on angiography in 13 patients. Among these 13 patients, 12 patients were symptomatic. Nine patients presenting with ICH underwent hematoma removal with additional Gamma Knife surgery (GKS; n = 4), GKS only (n = 2), or conservative treatment (n = 3). The 3 asymptomatic patients received conservative treatment, and 1 rebleeding episode was observed. Seven of 8 patients who underwent GKS as an initial or secondary treatment modality experienced a marked reduction in the AV shunt on follow-up angiography, but complete obliteration was not observed. coNclusioNs Poor lesion localization makes a vp-AVM challenging to treat. Symptomatic patients with a high-flow shunt are supposedly best treated with GKS, despite the fact that only 87.5% of the vp-AVMs treated this way showed a reduction in the malformation volume, and none were cured.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Review Of the Pertinent Literaturementioning

confidence: 99%

Section: Review Of the Pertinent Literaturementioning

confidence: 99%

See 3 more Smart Citations

Long-term treatment outcome of venous-predominant arteriovenous malformation

Jeon

Kim²,

Ahn

et al. 2016

JNS

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Thrombosis of a Developmental Venous Anomaly With Hemorrhagic Venous Infarction

Sepelyak

Gailloud²,

Jordan

2010

Arch Neurol

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Cerebral developmental venous anomalies: Current concepts

Ruíz¹,

Yılmaz²,

Gailloud³

2009

Annals of Neurology

206

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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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Developmental venous anomaly (DVA) with arterial component: a rare cause of intracranial haemorrhage

Abstract: DVA associated with intraparenchymal haemorrhage, but not related to cavernoma, was confirmed. Though very rare, DVA may present with non-cavernoma-related haemorrhage in the form of arterialized DVA or DVA with AVM.

Cited by 51 publications

References 15 publications

Long-term treatment outcome of venous-predominant arteriovenous malformation

Long-term treatment outcome of venous-predominant arteriovenous malformation

Thrombosis of a Developmental Venous Anomaly With Hemorrhagic Venous Infarction

Cerebral developmental venous anomalies: Current concepts

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