The Management of Symptomatic Cerebral Developmental Venous Anomalies: A Clinical Experience of 43 Cases.
BACKGROUND Developmental venous anomalies (DVAs) are rare vascular diseases becoming more frequently diagnosed. Most patients with DVAs have no clinical symptoms with the exception of a few patients with epilepsy, intracranial hemorrhage, or neuro-function deficit. There is still controversy with respect to treatment strategies for symptomatic DVAs. MATERIAL AND METHODS Forty-three cases of symptomatic DVAs from January 2006 to October 2015 were retrospectively reviewed and the imaging characteristics of DVAs by CT, MRI, and DSA and the treatment modalities for DVAs were studied. RESULTS Typical imaging characteristics of symptomatic DVAs were wedge or umbrella-shaped collections of dilated medullary veins converging in an enlarged subependymal or transcortical collecting vein, draining to the superficial or deep vein system. Based on location and draining vein features, symptomatic DVAs were tentatively classified into six different subtypes. Of the 43 cases, 19 were treated by surgical methods and 24 were treated conservatively. CONCLUSIONS We concluded that the rate of accompanying abnormalities in cases of symptomatic DVAs was high. Intracerebral hemorrhage was usually attributed to associated CMs or AVMs. The associated lesions and the branches responsible for bleeding could be resected while preserving the collecting vein as far as possible.
Department of Neurosurgery, Chinese PLA General Hospital, Beijing, China (mainland).
Xin-Guang
XG
Yu
Department of Neurosurgery, Chinese PLA General Hospital, Beijing, China (mainland).
Chen
C
Wu
Department of Neurosurgery, Air Force General Hospital of the Chinese PLA, Beijing, China (mainland).
Hui
H
Zhang
Department of Neurosurgery, Chinese PLA General Hospital, Beijing, China (mainland).
Zheng-Hui
ZH
Sun
Department of Neurosurgery, Chinese PLA General Hospital, Beijing, China (mainland).
Zhi-Qiang
ZQ
Cui
D000293:Adolescent; D000328:Adult; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging / Q000473:pathology; D002550:Cerebral Veins / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000473:pathology; D002561:Cerebrovascular Disorders / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D054079:Vascular Malformations / Q000473:pathology / Q000601:surgery; D055815:Young Adult