Neurointervention.  2013 Sep;8(2):120-124. 10.5469/neuroint.2013.8.2.120.

Multimodal Imaging Follow-up of a Thrombosed Developmental Venous Anomaly: CT, CT Angiography and Digital Subtraction Angiography

• Yi KS
• Cha SH
• Min KS

• KMID: 1784030
• DOI: http://doi.org/10.5469/neuroint.2013.8.2.120

Abstract

We report a rare case of thrombosed developmental venous anomaly (DVA) in a 31-year old male with hemorrhagic cerebral venous infarction at the initial clinical presentation. In this case, sequential CT, CT angiography and digital subtraction angiography demonstrated thrombotic obstruction of the venous drainage from DVA, its progressive recanalization and temporal evolution of the affected brain parenchyma. The relevant previous literatures were reviewed and summarized.

Keyword

Developmental venous anomaly; Computed tomography; Digital subtraction angiography; Cerebral venous thrombosis, Cerebral venous infarction

MeSH Terms

Angiography
Angiography, Digital Subtraction
Brain
Drainage
Follow-Up Studies
Humans
Infarction
Male

Figure

• 

  Fig. 1 CT and CT angiography (CTA) images at the day of initial clinical presentation.Multifocal hyperdense intracerebral hemorrhages (white arrow) and hypodense area (asterisk) are present in the left frontal lobe. Continuing hyperdensity (black arrow) courses from the hypodense area to the superior sagittal sinus (A). 3-dimensionally reconstructed CTA (B) shows no venous drainage to the superior sagittal sinus (white circle). Thrombosed vein (black arrow) and area of parenchymal staining, suggestive of venous congestion (white arrows) is evident on the axial source (C) and sagittal reformatted (D) images, and medullary and collecting veins in the adjacent brain (black arrowheads) are dilated and prominent (D).

• 

  Fig. 2 Follow-up images demonstrating progressive resolution of thrombosis and recanalization of draining vein from the DVA.DSA at one month shows intravenous filling defects in the left frontal DVA (black arrows), dilated medullary veins, delayed contrast wash-out and parenchymal staining in the lateral projection image (A). CTA at two month reveals patent draining vein (white circle) on three-dimensional reconstruction (B) and axial source image (C) demonstrates corresponding contrast enhancement (black arrow). Note parenchymal staining in the left frontal lobe, evident on the initial CTA (Fig. 1C), is no longer prominent (C). 0n two-year follow-up DSA, medullary veins are not engorged and draining vein is completely recanalized (D).

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