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

Abstract

SUMMARY:Stenosis of a DVA may result in chronic venous ischemia. We present 6 patients (3 men, 3 women; age range, 30 -79 years; mean age, 53 years) with unilateral calcification of the caudate and putamen on noncontrast CT. This calcification typically spared the anterior limb of the internal capsule. No patient presented with symptoms referable to the basal ganglia or had an underlying metabolic disorder or other process associated with calcium deposition. All patients subsequently underwent gadolinium-enhanced MR imaging and/or CTA or conventional angiography demonstrating the presence of an adjacent DVA. We hypothesize that chronic venous ischemia in the drainage territory of the DVA causes the abnormal mineralization. Greater recognition of this entity will prevent misinterpretation of this finding as acute hemorrhage and will prevent unnecessary and sometimes invasive evaluation in such patients. Furthermore, this entity should be considered in the differential diagnosis of unilateral basal ganglia hyperattenuation. , ABBREVIATIONS: AVM ϭ arteriovenous malformation; C ϭ caudate; Ca 2ϩ ϭ calcification; CTA ϭ CT angiography; DVA ϭ developmental venous anomaly; HA ϭ headache; ICH ϭ intracerebral hemorrhage; L ϭ left; NA ϭ not applicable; P ϭ putamen; R ϭ right; SZ ϭ seizure D

The Many Faces of Cerebral Developmental Venous Anomaly and Its Mimicks: Spectrum of Imaging Findings

“…Marked hyperdensity of the collecting vein may be a sign of a thrombosed DVA (Fig ) and warrants further investigation . CT can also demonstrate parenchymal abnormalities related to DVA such as calcification, overt hemorrhage, and atrophy . Contrast‐enhanced CT usually demonstrates enhancement of the DVA, which is best visualized on thin section CT venography as linear enhancing structures converging into a single enlarged draining vein …”

Hemispheric venous dysgenesis in a woman presenting with seizures, weakness and parkinsonism

“…Chronic venous ischaemia has been hypothesised as causing the focal atrophy and extensive unilateral calcification occasionally seen adjacent to a developmental venous anomaly (DVA) 1. We believe a similar process due to impaired venous drainage from the right hemisphere resulted in the extensive mineralisation seen in our patient's head CT and MRI.…”

Developmental Venous Anomaly Associated with Hemi-Parkinson’s Syndrome

“…The notion that a DVA can produce symptoms by itself is controversial, but isolated reports have described either obstructive hydrocephalus, venous infarction, hemorrhage, or other symptoms arising from a DVA without another associated vascular abnormality [3,[5][6][7][8][9][10][11][12][13][14][15]. Based on our case and these other isolated reports, it would appear that stenosis or occlusion of one of the venous radicles or the main trunk of the lesion could result in venous hypertension or ischemia.…”