Regional association of developmental venous anomalies with angiographically occult vascular malformations

Abstract

This study reviews the neuroradiological findings of 43 patients with a developmental venous anomaly in order to discuss the clinical significance of this entity. All patients underwent unenhanced and contrast-enhanced computer tomography and magnetic resonance tomography, as well as selective angiography, and were followed for at least 2 years. In 40% (17 of 43) of patients a cryptic vascular malformation was found in the proximity to the developmental venous anomaly. Neurological symptoms were present in 8 of 17 patients (47%) in this group. Patients with an isolated developmental venous anomaly had symptoms in 19% (5 of 26), but none of them had experienced a hemorrhage. Magnetic resonance was the most sensitive method for the diagnosis of both types of lesions and alterations of the adjacent parenchyma. These results further support that developmental venous anomalies represent a clinically benign entity. However, patients with an association of a developmental venous anomaly and a cryptic vascular malformation are at risk for hemorrhage from their angiographically occult vascular malformation. Magnetic resonance proved to be the imaging modality of choice for both entities and is appropriate for diagnosis and follow-up.

Brain Parenchymal Signal Abnormalities Associated with Developmental Venous Anomalies: Detailed MR Imaging Assessment

“…As in prior reports, [1][2][3] CMs were identified in association with DVAs (3.4%). In addition, we identified nonhemorrhagic signal-intensity alterations (increased signal intensity on FLAIR sequences) in 12.5%.…”

“…The association between DVAs and cavernous malformations (CMs) has been well described. [1][2][3] Intracranial hemorrhage in the absence of CM has been rarely reported as a complication of DVA. 4 There have also been a few case reports of nonhemorrhagic presumed venous infarction in the drainage territory of the DVA.…”

The Presentation and Clinical Course of Intracranial Developmental Venous Anomalies in Adults

“…Six of these studies did not match the selection criteria; one did not contain any information on clinical presentation or clinical course, 17 4 were earlier, smaller versions of studies included in this systematic review, 18 -21 and one was a precursor of the SIVMS data presented in this article. 7 The 15 remaining papers, [11][12][13]16,[22][23][24][25][26][27][28][29][30][31][32] reported on the clinical presentation of DVAs (Table 1), and 8 of these studies also described their clinical course (Table 3). 12,13,16,22,24,26,28,29 The largest study included 100 participants 12 ; 6 (40%) studies of clinical presentation 12,[23][24][25][26][27] ; and 3 (38%) studies of clinical course 12,24,26 included Ն50 participants.…”

“…Fifteen studies reported the clinical presentation of a total of 714 participants (Table 1), [11][12][13]16,[22][23][24][25][26][27][28][29][30][31][32] of whom at least 10% had an associated CM. Some studies were not generalizable because, for example, they were restricted to cerebellar DVAs 29 or included DVAs that had arterial components.…”

Unilateral Calcification of the Caudate and Putamen: Association with Underlying Developmental Venous Anomaly

“…3,5,14 The relationship of venous hypertension to dystrophic parenchymal calcification is not unique to DVAs and is also described in Sturge-Weber syndrome and dural arteriovenous fistulas and, recently, as a manifestation of congenital atresia of venous sinuses. 5,[15][16][17][18] We present a series of 6 cases demonstrating unilateral caudate and putaminal mineralization in association with a DVA. To our knowledge, only a single example of this association on cross-sectional imaging has been presented previously in the literature.…”