Developmental venous anomaly - cerebellum

Case contributed by Bruno Di Muzio

Presentation

First episode of seizure.

Patient Data

Age: 25 years
Gender: Female

There is a tiny area of increased density in the right cerebellar hemisphere and following contrast there is a leash of vessels surrounding it, extending to the cortical surface. The grey/white matter interface is preserved. There is a probable developmental venous anomaly in the right cerebellar hemisphere. A tiny area of increased density in the right cerebellar hemisphere may present an associated cavernoma. MRI correlation is suggested.

MRI Brain

mri

There are a bunch of small veins in the right cerebellar hemisphere draining predominantly towards a central vein that runs to the confluence of sinuses. There is also drainage through a thinner vein that runs anteriorly to tentorial veins reaching the right transverse sinus. No cavernous malformation is identified.

Conclusion: Developmental venous anomaly in the right cerebellar hemisphere. No signs of associated cavernous malformations.

Case Discussion

This case shows the typical appearance of a developmental venous anomaly (DVA) with a bunch of venous vessels in a "Medusa head". They are commonly located at the angle of ventricles, especially near the frontal horn of the lateral ventricles. 

There is no cavernous malformation associated, although it can coexist in ~20% of the DVAs. 

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