title: Magnetic resonance evolution of de novo formation of a cavernoma in a thrombosed developmental venous anomaly: a case report.
abstract: BACKGROUND
  Mechanisms that lead to de novo formations of nonfamilial-type cavernomas are not well understood. One of the interesting hypotheses is the causative relationship between developmental venous anomaly (DVA) and cavernoma formation. We report a unique case in which serial imaging demonstrated the evolution of de novo formation of a cavernoma in association with a thrombosed DVA. A detailed review of the causal hypothesis between a DVA and cavernoma is also provided.
  
  
  METHODS
  We report a 37-year-old female patient in whom a cavernoma-like lesion arose 1 year after the progressive thrombosis of a medullary (or caput medusa) vein of a DVA. The presence of an acute angulation in the draining vein may have prompted an intrinsic outflow restriction. Possible worsening of venous disequilibrium led to subsequent thrombus progression, venous congestion, and occlusion of the vein with venous dilation and signs of stasis on follow-up magnetic resonance imaging. Finally, this developed into a lobulated lesion with salt-and-pepper appearance at the converging region of medullary tributaries, which typified the classic features of a cavernoma.
  
  
  CONCLUSIONS
  Compared with other published cases of de novo cavernoma formation in relation to a DVA, our case, for the first time, allows us to witness the temporal evolution from a thrombosed DVA to the birth of a cavernoma around it. This supports the hypothesis that the cavernoma can be an acquired disease that arises from a DVA.
authors.affiliation: †Division of Neuroradiology, Department of Medical Imaging, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada; ‡Division of Neurosurgery, Department of Surgery, Taipei Cathay General Hospital, Taipei, Taiwan.
authors.forename: I-Chang
authors.initials: IC
authors.lastname: Su
authors.forename: Pradeep
authors.initials: P
authors.lastname: Krishnan
authors.forename: Sapna
authors.initials: S
authors.lastname: Rawal
authors.forename: Timo
authors.initials: T
authors.lastname: Krings
mesh_terms: D000328:Adult; D016543:Central Nervous System Neoplasms / Q000150:complications* / Q000473:pathology*; D002550:Cerebral Veins / Q000002:abnormalities*; D005260:Female; D020786:Hemangioma, Cavernous, Central Nervous System / Q000150:complications* / Q000473:pathology*; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D013927:Thrombosis / Q000473:pathology