Unusual pattern of a deep developmental venous anomaly on CT and MR studies.
OBJECTIVE
This article focuses on an unusual cross-sectional imaging pattern of a deep developmental venous anomaly (DVA). Since these anomalies are nonpathologic, they must not be interpreted as a disease that requires further costly workup and potentially injurious procedures (cerebral angiography).


METHODS
Two women aged 19 (Case 1) and 30 (Case 2) years sought medical evaluation for severe headaches. Both patients underwent CT, MRI, and conventional cerebral angiography. Case 1 also underwent MR venography.


RESULTS
The diagnosis of an unusual DVA in Case 1 was confirmed only after conventional catheter angiography and a follow-up MR venogram. In Case 2 the diagnosis was inferred based upon the CT, MRI, and conventional angiography results and the marked similarity to Case 1. The presumptive diagnosis in Case 2 would not have been made with confidence without the prior experience of managing Case 1.


CONCLUSIONS
DVAs (venous angiomas) are extreme variations in the pattern of intracranial venous drainage. These two case reports highlight an unusual pattern of this benign entity. Individuals interpreting cross-sectional imaging studies should be cognizant of this pattern.
Division of Neuroradiology, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center 85013-4496, USA.
N M
NM
Borden
M H
MH
Khayata
B L
BL
Dean
R A
RA
Flom
D000328:Adult; D001932:Brain Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology; D002533:Cerebral Angiography; D002550:Cerebral Veins / Q000002:abnormalities*; D005260:Female; D006391:Hemangioma / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D014057:Tomography, X-Ray Computed