Improved Characterization of a Developmental Venous Anomaly with a Varix-like Lesion and a Venous Malformation by Venous 3D-DSA

Excerpt

Developmental venous anomalies (DVA) are the most frequently encountered asymptomatic cerebral vascular malformations and are often found incidentally on routine computed tomography angiography (CTA) and magnetic resonance imaging (MRI) studies. In a series of 4069 brain autopsies, the reported incidence was 2.6% [1]. While the association of DVAs with cavernous malformations is well known, they are rarely associated with a venous varix. Only 15 cases have been reported which described usually a single venous ectasia or varix draining the DVA based on either MRI, CT or 2D digital subtraction angiography (DSA) findings [2‐16]. In none of these reports was 3D rotational angiography or venous phase 3D-DSA utilized to further evaluate the abnormal venous morphology. Herein, we present the first case of a DVA associated with a varix-like lesion combined with an additional venous malformation (VM). The exact characterization and detailed study of this complex lesion was initially challenging using MRI and 2D-DSA alone and only possible after obtaining a venous 3D-DSA. …