Clinical and imaging feature of 3 patients with combined developmental venous anomalies and cerebral cavernous malformations

Abstract

Objective To investigate the clinical, neuroradiologic characteristics and possible causes in 3 patients with combined developmental venous anomalies (DVAs) and cerebral cavernous malformations(CCM). Methods The clinical examination, magnetic resonance imaging (MRI) T1-weighted (T1WI), T2-weighted (T2WI), susceptibility-weighted imaging (SWI) or T2 fast field echo(T2 FFE), contrast-enhanced MRI at 1.5 T field strength and digital substrate angiography were performed in 3 patients. Results Three patients presented with the seizure, vertigo, and dizziness respectively. MRI findings of reticulated “popcorn like” lesion with complete hemosiden rim showed typical sign of CCM. DSA, contrast-enhanced MRI and MRI-SWI revealed the caput medusae of the medullary veins and collected veins which was drained into subcortical and deep venous system, which indicated DVAs in 3 patients. The angulated medullary veins and collected veins in approaching distal zone of CCM were observed. Conclusion DVAs can be combined with CCM. The angulated medullary veins and collected veins combined with CCM in same territory reveals that the angioarchitectural factors is a key factor in pathogenesis of cavernous malformation. Key words: Central nervous system vascular malformations; Hemangioma; cavernous; central nervous system; Magnetic resonance imaging; Cerebral angiography