Developmental venous anomaly (DVA) with arterial component: a rare cause of intracranial haemorrhage.
BACKGROUND
To examine the clinical and radiologic findings of patients with developmental venous anomaly (DVA) associated with intracranial haemorrhage but unrelated to cavernoma.


METHODS
Computed tomography (CT) was used to obtain intracranial images from seven patients ranging in age from 6 to 51 years. Magnetic resonance imaging (MRI) was then performed on six patients, and two patients were further examined via CT angiography. Finally, digital subtraction angiography (DSA) was performed to confirm the initial diagnosis.


RESULTS
CT showed intraparenchymal supratentorial haemorrhage in all patients. The combined imaging modalities eventually confirmed a diagnosis of arterialized DVA in four patients and arterialized DVA associated with arteriovenus malformation (AVM) in three. Two patients were managed symptomatically, two underwent radiosurgery, one underwent surgery, one underwent combined embolisation plus radiosurgery and the remaining patient underwent combined embolisation plus surgery. Two patients died, one as a result of re-bleeding, and the other due to radiation necrosis. The mean follow-up period was 33 months (6 months to 6 years) for the remaining five patients with favourable outcome.


CONCLUSIONS
DVA associated with intraparenchymal haemorrhage, but not related to cavernoma, was confirmed. Though very rare, DVA may present with non-cavernoma-related haemorrhage in the form of arterialized DVA or DVA with AVM.
Oran
Ismail
I
Department of Radiology, Ege University Medical School, 35100, Izmir, Turkey. ismailoran@gmail.com
Kiroglu
Yilmaz
Y
Yurt
Alaattin
A
Ozer
Fisun Demircivi
FD
Acar
Feridun
F
Dalbasti
Tayfun
T
Yagci
Baki
B
Sirikci
Akif
A
Calli
Cem
C
D000293:Adolescent; D000328:Adult; D015901:Angiography, Digital Subtraction; D001921:Brain / Q000098:blood supply / Q000473:pathology; D002533:Cerebral Angiography; D002550:Cerebral Veins / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000473:pathology; D002648:Child; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D020300:Intracranial Hemorrhages / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult
Surg Neurol. 1986 Mar;25(3):227-32
3945903
Neurosurgery. 1993 Aug;33(2):179-88; discussion 188
8367039
Hiroshima J Med Sci. 2003 Dec;52(4):91-7
14760997
Neuroradiology. 2000 Jun;42(6):455-7
10929309
Eur Radiol. 1996;6(1):30-7
8797947
J Neurol Neurosurg Psychiatry. 1999 Aug;67(2):234-8
10407000
J Neurosurg. 1996 Jul;85(1):9-13
8683287
Neuroradiology. 2007 Dec;49(12):987-95
17703296
Neurosurgery. 1998 Aug;43(2):347-51; discussion 351-2
9696089
Neurosurg Rev. 1986;9(3):233-42
3550523
J Neurosurg. 1993 Apr;78(4):531-6
8110208
Interv Neuroradiol. 1997 Dec 20;3(4):329-32
20678365
Interv Neuroradiol. 2006 Jun 15;12(2):113-21
20569563
AJR Am J Roentgenol. 1992 Dec;159(6):1299-307
1442406
Surg Neurol. 2001 Sep;56(3):170-4
11597644
Neurosurgery. 1999 Jun;44(6):1328-34; discussion 1334-5
10371635
Neurosurgery. 1998 Aug;43(2):195-200; discussion 200-1
9696070
AJNR Am J Neuroradiol. 1998 Jan;19(1):51-7
9432157
J Neurosurg. 2008 Jun;108(6):1142-7
18518718
AJNR Am J Neuroradiol. 1994 Aug;15(7):1247-54; discussion 1255-7
7976933