Spontaneous Intracerebral Hemorrhage Caused by an Unusual Association of Developmental Venous Anomaly and Arteriovenous Malformation

Abstract

<jats:p> We describe three patients who presented with spontaneous intracerebral hemorrhage resulting from the close association of developmental venous anomaly (DVA) and arteriovenous malformation (AVM). Angioarchitecturally, either the DVA formed the draining pathway for the AVM or they shared a common venous channel. The AVMs were treated by targeted embolization and the DVAs were carefully preserved. It is suggested that the unusual association of an AVM with the less flexible DVA was the cause of hemorrhage. </jats:p>

Developmental venous anomaly : MR and angiographic features

“…Enhanced CT and MRI can show the draining vein of the DVA as a linear area of enhancement, that courses from the deep white matter to a superficial or deep vein or to a dural sinus. 2D MRI (time-of-flight) angiography can show the pathognomic features of a DVA in more than 85% of cases (10,13). 2D-MRA is superior to 3D methods for the imaging of slow flow vessels, like veins, because they have less saturation effects.…”

“…Nowadays they are seen with high frequency as incidental finding at CT or MRI. Invasive imaging is nowadays mostly reserved for complicated cases or to exclude associated vascular lesions (4,10,13).…”

Developmental Venous Anomaly Serving as a Draining Vein of Brain Arteriovenous Malformation

“…Th is association results in a higher tendency to bleeding from additional hemodynamic stress on the delicate DVA structure 6 . Th ey can also present with focal neurologic defi cit, seizures, and brain infarctions.…”

Developmental venous anomaly coexisting with a true arteriovenous malformation: a rare clinical entity

“…This association is known to result in a higher propensity for bleeding from additional hemodynamic stress on the delicate DVA structure 8. Other presentations include seizure, non-hemorrhagic focal neurologic deficit and brain infarctions.…”