Presentation
Vertigo.
Patient Data
Within the left cerebellar hemisphere is a developmental venous anomaly draining to a vein coursing over the tentorium and then into the transverse sinus. It has characteristic appearances. It is associated with a 6 mm high T2, peripherally and low signal, with blooming on gradient echo lesion, characteristic of a low flow cavernous venous malformation (cavernoma).
This is an isolated abnormality, with the remainder of the brain appearing normal. Specifically, the remainder of the posterior fossa including the internal acoustic meatus are, appear unremarkable. No restricted diffusion or evidence of prior infarcts.
MRA is unremarkable, with no abnormal vessels seen in the region of the aforementioned DVA/cavernoma.
Conclusion:
Left cerebellar hemisphere developmental venous anomaly (DVA) with associated cavernoma; a common association. Otherwise normal examination.
Case Discussion
Developmental venous anomalies (DVA) and cavernomas frequently co-exist and are presumably part of a spectrum of vascular developmental disorders. It is usually believed that DVAs do not bleed and that if a hemorrhage is seen in the vicinity of a DVA then an underlying cavernous malformations is likely present. The exception to this rule is if the DVA thromboses, in which case you may develop a venous infarct.
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