Parenchymal abnormalities associated with developmental venous anomalies.
BACKGROUND
To report a retrospective series of 84 cerebral developmental venous anomalies (DVAs), focusing on associated parenchymal abnormalities within the drainage territory of the DVA.


METHODS
DVAs were identified during routine diagnostic radiological work-up based on magnetic resonance imaging (MRI) (60 cases), computed tomography (CT) (62 cases) or both (36 cases). Regional parenchymal modifications within the drainage territory of the DVA, such as cortical or subcortical atrophy, white matter density or signal alterations, dystrophic calcifications, presence of haemorrhage or a cavernous-like vascular malformation (CVM), were noted. A stenosis of the collecting vein of the DVA was also sought for.


RESULTS
Brain abnormalities within the drainage territory of a DVA were encountered in 65.4% of the cases. Locoregional brain atrophy occurred in 29.7% of the cases, followed by white matter lesions in 28.3% of MRI investigations and 19.3% of CT investigations, CVMs in 13.3% of MRI investigations and dystrophic calcification in 9.6% of CT investigations. An intracranial haemorrhage possibly related to a DVA occurred in 2.4% cases, and a stenosis on the collecting vein was documented in 13.1% of cases. Parenchymal abnormalities were identified for all DVA sizes.


CONCLUSIONS
Brain parenchymal abnormalities were associated with DVAs in close to two thirds of the cases evaluated. These abnormalities are thought to occur secondarily, likely during post-natal life, as a result of chronic venous hypertension. Outflow obstruction, progressive thickening of the walls of the DVA and their morphological organization into a venous convergence zone are thought to contribute to the development of venous hypertension in DVA.
San Millán Ruíz
Diego
D
Division of Interventional Neuroradiology, Johns Hopkins Hospital, 600 N. Wolfe Street, Baltimore, MD 21287, USA. dsanmil1@jhmi.edu
Delavelle
Jacqueline
J
Yilmaz
Hasan
H
Gailloud
Philippe
P
Piovan
Enrico
E
Bertramello
Alberto
A
Pizzini
Francesca
F
Rüfenacht
Daniel A
DA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001284:Atrophy; D002114:Calcinosis / Q000175:diagnosis / Q000503:physiopathology; D002543:Cerebral Hemorrhage / Q000175:diagnosis / Q000503:physiopathology; D002550:Cerebral Veins / Q000002:abnormalities* / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D020786:Hemangioma, Cavernous, Central Nervous System / Q000175:diagnosis / Q000503:physiopathology; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds; D014057:Tomography, X-Ray Computed
D003287:Contrast Media; D009942:Organometallic Compounds; C090600:gadobutrol; D019786:Gadolinium DTPA
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