The association between cerebral developmental venous anomaly and concomitant cavernous malformation: an observational study using magnetic resonance imaging

Abstract

BackgroundSome studies reported that cerebral developmental venous anomaly (DVA) is often concurrent with cavernous malformation (CM). But there is lack of statistical evidence and study of bulk cases. The factors associated with concurrency are still unknown. The purpose of this study was to determine the prevalence of concomitant DVA and CM using observational data on Chinese patients and analyze the factors associated with the concurrency.MethodsThe records of all cranial magnetic resonance imaging (MRI) performed between January 2001 and December 2012 in Beijing Tiantan Hospital were reviewed retrospectively. The DVA and CM cases were selected according to imaging reports that met diagnostic criteria. Statistical analysis was performed using the Pearson chi-square statistic for binary variables and multivariable logistic regression analysis for predictors associated with the concurrent CM.ResultsWe reviewed a total of 165,230 cranial MR images performed during the previous 12 year period, and identified 1,839 cases that met DVA radiographic criteria. There were 205 patients who presented concomitant CM among the 1,839 DVAs. The CM prevalence in DVA cases (11.1%) was significantly higher than that in the non-DVA cases (2.3%) (P<0.01). In the multivariate analysis, we found that DVAs with three or more medullary veins in the same MRI section (adjusted OR = 2.37, 95% CI: 1.73-3.24), infratentorial DVAs (adjusted OR = 1.71, 95% CI: 1.26-2.33) and multiple DVAs (adjusted OR = 2.08, 95% CI: 1.04-4.16) have a higher likelihood of being concomitant with CM.ConclusionsCM are prone to coexisting with DVA. There is a higher chance of concurrent CM with DVA when the DVA has three or more medullary veins in the same MRI scanning section, when the DVA is infratentorial, and when there are multiple DVAs. When diagnosing DVA cases, physicians should be alerted to the possibility of concurrent CM.

The Management of Symptomatic Cerebral Developmental Venous Anomalies: A Clinical Experience of 43 Cases

“…Type D and E were infratentorial DVAs, the former ones located in cerebellum while the latter were located in brain stem. Infratentorial DVAs have been associated with a high ratio of CM compared with supratentorial DVAs (10/12 vs. 3/27, p =0.0258) and bleeding often occurred (10/12, 83.3%) [21,22]. Infratentorial cavernous hemangioma could be resected, and these collecting veins should be preserved.…”

Oxidative stress and inflammation in cerebral cavernous malformation disease pathogenesis: Two sides of the same coin

“…Notably, while the sporadic form of the illness typically presents as a solitary lesion, the familial form is characterized by the presence of multiple CCM lesions, which are associated with cutaneous and retinal vascular lesions in 9% and 5% of fCCM cases, respectively. Conversely, in contrast to fCCM cases, CCM lesions of sCCM cases are frequently associated with a developmental venous anomaly (DVA), suggesting the possibility of a different developmental mechanism (Meng et al, 2014, Petersen et al, 2010). …”

Imaging of Nontraumatic Neuroradiology Emergencies

“…The presence of an associated developmental venous anomaly, appearing as a confluence of veins into a central trunk ("medusa head"), is a confirmatory finding. 24 CMs may be multiple.…”