[Developmental venous anomaly presenting as a brain parenchymal abnormality mimicking a brain tumor:a report of 3 cases and review of literature].
Cases of brain parenchymal abnormality caused by a developmental venous anomaly (DVA) are rare. The purpose of this paper is to report 3 cases where DVA presented as abnormal lesions on magnetic resonance imaging (MRI) scans, mimicking brain tumors such as gliomas. CASE 1: the patient was a 60-year-old woman who underwent MRI for mild memory disturbance. MRI revealed an abnormal lesion in the left temporal lobe, and a diagnosis of glioma was considered. She was transferred to our hospital for surgery 6 days later when the lesion had spontaneously decreased in size. Gadolinium-enhanced MRI (Gd-MRI) and conventional angiography revealed dilated medullary veins in the lesion. The patient was followed-up conservatively; the lesion further decreased in size during the follow-up period, and only slight atrophy remained. CASE 2: the patient was a 17-year-old girl with left hemiparesis and facial palsy. She was transferred to our hospital for surgery of an abnormal lesion in the right frontal lobe. The lesion showed high intensity on T(2)weighted MRI and enlarged 2 weeks later, mimicking a glioma. Over the next 2 weeks, the size of the lesion spontaneously decreased, and the patient's symptoms improved. Gd-MRI and conventional angiography revealed the presence of typical caput medusae. The patient has been followed-up conservatively, and no further changes have been observed. CASE 3: the patient was a 61-year-old man whose T(2) weighted MRI scan incidentally revealed an abnormal high intensity lesion in the right frontal lobe. Gd-MRI was helped to detect the radially dilated medullary veins.


CONCLUSIONS
the incidence of brain parenchymal abnormalities caused by DVAs may be higher than that reported previously. DVA should be included in the differential diagnosis of high intensity lesions on T(2) weighted MRI.
Department of Neurosurgery, Tohoku University Graduate School of Medicine, Japan.
Takahiro
T
Morita
Hiroaki
H
Shimizu
Toshihiro
T
Kumabe
Atsushi
A
Saito
Teiji
T
Tominaga
D000293:Adolescent; D001927:Brain Diseases / Q000175:diagnosis* / Q000209:etiology* / Q000473:pathology; D001932:Brain Neoplasms; D002550:Cerebral Veins / Q000002:abnormalities* / Q000473:pathology*; D003937:Diagnosis, Differential; D005260:Female; D005910:Glioma; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged