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Coexistence of Intracranial Developmental Venous Anomaly and Cavernoma; When, Where and How

Year 2021, Volume: 31 Issue: 4, 349 - 353, 15.12.2021
https://doi.org/10.54005/geneltip.1036524

Abstract

Objective: Cavernoma and DVA (Developmental venous anomalies) association is the most common mixed type vascular malformation. In this study, vascular and epidemiological features of DVA that may affect the development of cavernoma were investigated.

Material and Methods: Patients with cavernoma and DVA were detected by scanning the patients with contrast-enhanced brain MRI in our hospital between January 2016 and February 2019 from the database. Age, gender, location of lesions, cavernoma size, maximum number of vessels in a single section of DVA, drainage direction and drainage location of the collecting vein of these patients were determined.

Results: Of the 28 patients included in the study, 15 were female (56%) and the average age was 45 (17-82). Although supratentorial location was frequent, a statistically significant increase was observed in infratentorial ones. Subependymal drainage was present in 61% of the cases and this rate was significant in men. Cavernoma sizes were larger in GVA with top-down drainage of the collecting vein in the Z-axis.

Conclusion: The possibility of cavernoma is higher in GVA that is located infratentorially and draining into the subependymal vein, and the follow-up of patients with MRI is very important.

References

  • Koc K, Anik I, Akansel Q, Anik Y, Ceylan S. Massive intracerebral haemorrage due to developmental venous anomaly. Br J Neurosurg. 2007;21(4):403–5
  • Ostertun B, Solymosi L. Magnetic resonance angiography of cerebral developmental venous anomalies: its role in differential diagnosis. Neuroradiology. 1993;35:97–104
  • Boukobza M, Enjolras O, Guichard JP, et al. Cerebral developmental venous anomalies associated with head and neck venous malformations. AJNR Am J Neuroradiol. 1996;17:987–94
  • Oran I, Kiroglu Y, Yurt A et al. Developmental venous anomaly (DVA) with arterial component: a rare cause of intracranial haemorrhage. Neuroradiology. 2009; 51(1):25–32
  • Linscott LL, Leach JL, Zhang B, Jones BV. Brain parenchymal signal abnormalities associated with developmental venous anomalies in children and young adults. AJNR Am J Neuroradiol. 2014;35:1600–7
  • Jaehong Kim. Introduction to cerebral cavernous malformation: a brief review. BMB Rep. 2016;49:255–62
  • Awad IA, Robinson JR, Mohanty S, Estes ML. Mixed vascular malformations of the brain: clinical and pathogenetic considerations. Neurosurgery. 1993;33:179–88
  • Comey CH, Kondziolka D, Yonas H. Regional parenchymal enhancement with mixed cavernous/venous malformations of the brain. Case report. J Neurosurg. 1997;86:155–58
  • Hegde AN, Mohan S, Lim CC. CNS cavernous haemangioma: "popcorn" in the brain and spinal cord. Clinical radiology. 2012;67 (4): 380-8
  • Young A, Poretti A, Bosemani T et al. Sensitivity of susceptibility-weighted imaging in detecting developmental venous anomalies and associated cavernomas and microhemorrhages in children. Neuroradiology. 2017; 59:797–802.
  • Brunereau L, Labauge P, Tournier-Lasserve E et-al. Familial form of intracranial cavernous angioma: MR imaging findings in 51 families. French Society of Neurosurgery. Radiology. 2000;214 (1): 209-16
  • Kamezawa T, Hamada J-I, Niiro M et al. Clinical implications of associated venous drainage in patients with cavernous malformation. J Neurosurg. 2005; 102:24–8
  • Rammos SK, Maina R, Lanzino G. Developmental venous anomalies: current concepts and implications for management. Neurosurgery. 2009;65:20-9
  • Dammann P, Wrede KH, Maderwald S, et al. The venous angioarchitecture of sporadic cerebral cavernous malformations: a susceptibility weighted imaging study at 7T MRI. J Neurol Neurosurg Psychiatry. 2013;84:194-200
  • Porter R, Detwiler P, Spetzler R, et al. Cavernous malformations of the brainstem: experience with 100 patients. J Neurosurg. 1999;90:50-8
  • McCormick WF. The pathology of vascular ("arteriovenous") malformations. J Neurosurg. 1966;24(4):807-16
  • Perrini P, Lanzino G. The association of venous developmental anomalies and cavernous malformations: pathophysiological, diagnostic, and surgical considerations. Neurosurg Focus. 2006;15;21(1):e5
  • Hussain JZ, Ray A, Hughes DG, Leggate JR. Complex developmental venous anomaly of the brain. Acta Neurochir (Wien). 2002;144(5):501–4
  • Maeder P, Gudinchet F, Meuli R, de Tribolet N. Development of a cavernous malformation of the brain. AJNR Am J Neuroradiol. 1998;19(6):1141–3
  • Meng G, Bai C, Yu T, et al. The association between cerebral developmental venous anomaly and concomitan cavernous malformation: an observational study using magnetic resonance imaging. BMC Neurol. 2014;14:50.
  • Kumar S, Lanzino G, Brinjikji W, Hocquard KW, Flemming KD. Infratentorial Developmental Venous Abnormalities and Inflammation Increase Odds of Sporadic Cavernous Malformation. J Stroke Cerebrovasc Dis. 2019 Jun;28(6):1662-7
  • Cakirer S: De novo formation of a cavernous malformation of the brain in the presence of a developmental venous anomaly. Clin Radiol. 2003,58(3):251–6
  • Hong YJ, Chung TS, Suh SH, et al. The angioarchitectural factors of the cerebral developmental venous anomaly; can they be the causes of concurrent sporadic cavernous malformation. Neuroradiology. 2010;52(10):883–91

İntrakraniyal Gelişimsel Venöz Anomali ve Kavernom Birlikteliği; Ne zaman, Nerede ve Nasıl

Year 2021, Volume: 31 Issue: 4, 349 - 353, 15.12.2021
https://doi.org/10.54005/geneltip.1036524

Abstract

Amaç: Kavernom ve gelişimsel venöz anomali (GVA) birlikteliği en sık görülen miks tip vasküler malformasyondur. Bu çalışmada kavernom gelişimine etki edebilecek GVA vasküler özellikleri ve epidemiyolojik özellikler araştırılmıştır.

Gereç ve Yöntem: Ocak 2016- Şubat 2019 tarihleri arasında hastanemizde kontrastlı beyin manyetik rezonans (MR) görüntüleme yapılan hastalar veri tabanından taranarak bu görüntülerde kavernom ve GVA’sı bulunan hastalar tespit edildi. Bu hastalara ait yaş, cinsiyet, lezyonların yerleşim yeri, kavernom boyutu, GVA’nın tek kesitteki maksimum damar sayısı, toplayıcı venin drenaj yönü ve drenaj yeri belirlendi.

Bulgular: Çalışmaya dahil edilen 28 hastanın 15’i kadın (%56) olup, yaş ortalaması 45’ti (17-82). Supratentoryal yerleşim sık olmakla birlikte infratentoryal olanlarda istatistiksel olarak kavernom sayısında anlamlı artış görüldü. Subepandimal drenaj vakaların %61’inde mevcuttu ve bu oran erkeklerde anlamlı düzeydeydi. Z ekseninde toplayıcı ven drenajı yukarıdan aşağı yönde olan GVA’larda eşlik eden kavernom boyutları daha büyüktü.

Sonuç: İnfratentoryal yerleşimli, subepandimal vene drene olan GVA’larda kavernom görülme olasılığı daha yüksek olup hastaların MR ile takibi oldukça önemlidir.

References

  • Koc K, Anik I, Akansel Q, Anik Y, Ceylan S. Massive intracerebral haemorrage due to developmental venous anomaly. Br J Neurosurg. 2007;21(4):403–5
  • Ostertun B, Solymosi L. Magnetic resonance angiography of cerebral developmental venous anomalies: its role in differential diagnosis. Neuroradiology. 1993;35:97–104
  • Boukobza M, Enjolras O, Guichard JP, et al. Cerebral developmental venous anomalies associated with head and neck venous malformations. AJNR Am J Neuroradiol. 1996;17:987–94
  • Oran I, Kiroglu Y, Yurt A et al. Developmental venous anomaly (DVA) with arterial component: a rare cause of intracranial haemorrhage. Neuroradiology. 2009; 51(1):25–32
  • Linscott LL, Leach JL, Zhang B, Jones BV. Brain parenchymal signal abnormalities associated with developmental venous anomalies in children and young adults. AJNR Am J Neuroradiol. 2014;35:1600–7
  • Jaehong Kim. Introduction to cerebral cavernous malformation: a brief review. BMB Rep. 2016;49:255–62
  • Awad IA, Robinson JR, Mohanty S, Estes ML. Mixed vascular malformations of the brain: clinical and pathogenetic considerations. Neurosurgery. 1993;33:179–88
  • Comey CH, Kondziolka D, Yonas H. Regional parenchymal enhancement with mixed cavernous/venous malformations of the brain. Case report. J Neurosurg. 1997;86:155–58
  • Hegde AN, Mohan S, Lim CC. CNS cavernous haemangioma: "popcorn" in the brain and spinal cord. Clinical radiology. 2012;67 (4): 380-8
  • Young A, Poretti A, Bosemani T et al. Sensitivity of susceptibility-weighted imaging in detecting developmental venous anomalies and associated cavernomas and microhemorrhages in children. Neuroradiology. 2017; 59:797–802.
  • Brunereau L, Labauge P, Tournier-Lasserve E et-al. Familial form of intracranial cavernous angioma: MR imaging findings in 51 families. French Society of Neurosurgery. Radiology. 2000;214 (1): 209-16
  • Kamezawa T, Hamada J-I, Niiro M et al. Clinical implications of associated venous drainage in patients with cavernous malformation. J Neurosurg. 2005; 102:24–8
  • Rammos SK, Maina R, Lanzino G. Developmental venous anomalies: current concepts and implications for management. Neurosurgery. 2009;65:20-9
  • Dammann P, Wrede KH, Maderwald S, et al. The venous angioarchitecture of sporadic cerebral cavernous malformations: a susceptibility weighted imaging study at 7T MRI. J Neurol Neurosurg Psychiatry. 2013;84:194-200
  • Porter R, Detwiler P, Spetzler R, et al. Cavernous malformations of the brainstem: experience with 100 patients. J Neurosurg. 1999;90:50-8
  • McCormick WF. The pathology of vascular ("arteriovenous") malformations. J Neurosurg. 1966;24(4):807-16
  • Perrini P, Lanzino G. The association of venous developmental anomalies and cavernous malformations: pathophysiological, diagnostic, and surgical considerations. Neurosurg Focus. 2006;15;21(1):e5
  • Hussain JZ, Ray A, Hughes DG, Leggate JR. Complex developmental venous anomaly of the brain. Acta Neurochir (Wien). 2002;144(5):501–4
  • Maeder P, Gudinchet F, Meuli R, de Tribolet N. Development of a cavernous malformation of the brain. AJNR Am J Neuroradiol. 1998;19(6):1141–3
  • Meng G, Bai C, Yu T, et al. The association between cerebral developmental venous anomaly and concomitan cavernous malformation: an observational study using magnetic resonance imaging. BMC Neurol. 2014;14:50.
  • Kumar S, Lanzino G, Brinjikji W, Hocquard KW, Flemming KD. Infratentorial Developmental Venous Abnormalities and Inflammation Increase Odds of Sporadic Cavernous Malformation. J Stroke Cerebrovasc Dis. 2019 Jun;28(6):1662-7
  • Cakirer S: De novo formation of a cavernous malformation of the brain in the presence of a developmental venous anomaly. Clin Radiol. 2003,58(3):251–6
  • Hong YJ, Chung TS, Suh SH, et al. The angioarchitectural factors of the cerebral developmental venous anomaly; can they be the causes of concurrent sporadic cavernous malformation. Neuroradiology. 2010;52(10):883–91
There are 23 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Original Article
Authors

Elif Gözgeç This is me

Hayri Oğul This is me

Publication Date December 15, 2021
Submission Date January 4, 2021
Published in Issue Year 2021 Volume: 31 Issue: 4

Cite

Vancouver Gözgeç E, Oğul H. İntrakraniyal Gelişimsel Venöz Anomali ve Kavernom Birlikteliği; Ne zaman, Nerede ve Nasıl. Genel Tıp Derg. 2021;31(4):349-53.