Caput medusae sign (developmental venous anomaly)

Last revised by Frank Gaillard on 21 Nov 2023

The caput medusae sign also sometimes known as a palm tree sign refers to developmental venous anomalies of the brain, where a number of veins converge centrally into a single draining vein. 

The sign is seen on both CT and MRI when contrast medium is administered. Angiographically the caput medusae appearance is seen only in the venous phase.

The association with cavernous hemangiomas defines this as a mixed vascular malformation.

History and etymology

Caput is the Latin for head, and the sign literally translates as head of Medusa 4. The appearance is reminiscent of the hair of Medusa, one of the three Gorgons of Greek mythology. The Gorgons had venomous snakes for hair and their countenance was said to be so terrifying that anyone who looked upon them was literally turned to stone. Medusa was encountered and beheaded by the Greek demigod hero Perseus 3,5.

See also

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