title: De novo formation of cerebral cavernous malformation adjacent to existing developmental venous anomaly - an effect of change in venous pressure associated with management of a complex dural arterio-venous fistula.
abstract: This is a case report of de novo development of two cerebral cavernous malformations adjacent to existing developmental venous anomalies. The development of cavernomas was noted over a follow-up period of 10 years. These developments happened during the course of staged endovascular management of a complex dural arterio-venous fistula along the right sphenoid wing. The patient presented with a proptosis secondary to lympho-haemangiomatous lesion of the fronto-orbital region and a high-flow right sphenoid wing dural arterio-venous fistula. During the initial period of conservative management of the dural arterio-venous fistula, he developed de novo cavernous malformations in the left mesial temporal lobe adjacent to a developmental venous anomaly in the temporal lobe, and along with this there was engorgement of deep veins related to another existing developmental venous anomaly in the brainstem. Later during the course of endovascular treatment of the dural arterio-venous fistula, a large brainstem cavernoma developed adjacent to the brainstem developmental venous anomaly. This case report discusses the cause-effect relationship of venous pressure changes related to management of dural arterio-venous fistula and de novo formation of cerebral cavernous malformations adjacent to existing developmental venous anomalies.
authors: Sapthagiri Institute of Medical Sciences and Research Centre, India.
authors: Hariprakash
authors: H
authors: Chakravarthy
authors: Department of Neurosurgery, Chang Gung Memorial Hospital at Linkou, Taiwan.|College of Medicine and School of Medical Technology, Chang Gung University, Taoyuan, Taiwan.
authors: Tzu-Kang
authors: TK
authors: Lin
authors: Department of Diagnostic Radiology, Chang Gung Memorial Hospital at Keelung, Taiwan.|College of Medicine and School of Medical Technology, Chang Gung University, Taoyuan, Taiwan.
authors: Yao-Liang
authors: YL
authors: Chen
authors: Division of Neuroradiology, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, Taiwan.|College of Medicine and School of Medical Technology, Chang Gung University, Taoyuan, Taiwan.
authors: Yi-Ming
authors: YM
authors: Wu
authors: Division of Neuroradiology, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, Taiwan.|College of Medicine and School of Medical Technology, Chang Gung University, Taoyuan, Taiwan.
authors: Chin-Hua
authors: CH
authors: Yeh
authors: Division of Neuroradiology, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, Taiwan hfwong4720@gmail.com.|College of Medicine and School of Medical Technology, Chang Gung University, Taoyuan, Taiwan.
authors: Ho-Fai
authors: HF
authors: Wong
mesh_terms: D000328:Adult; D015901:Angiography, Digital Subtraction; D001164:Arteriovenous Fistula / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D020785:Central Nervous System Vascular Malformations / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D018450:Disease Progression; D004621:Embolization, Therapeutic; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D013702:Temporal Lobe / Q000000981:diagnostic imaging; D014690:Venous Pressure / Q000502:physiology*
keywords: Cavernoma; arteriovenous fistula; cavernous angioma; de novo; developmental venous anomaly