scholarly journals Developmental venous anomaly presenting as a spontaneous intraparenchymal hematoma without thrombosis

2016 ◽  
Vol 29 (6) ◽  
pp. 465-469 ◽  
Author(s):  
Nitin Agarwal ◽  
Giulio Zuccoli ◽  
Geoffrey Murdoch ◽  
Brian T Jankowitz ◽  
Stephanie Greene
Keyword(s):  
Magnetic Resonance ◽  
Vascular Malformation ◽  
Vascular Malformations ◽  
Developmental Venous Anomaly ◽  
Venous Infarction ◽  
Delayed Imaging ◽  
Cerebral Angiogram ◽  
Developmental Venous Anomalies ◽  
Magnetic Resonance Imaging Mri

Introduction Developmental venous anomalies (DVAs) are cited as the most common cerebral vascular malformations. Still, intracerebral hematomas are rarely thought to be caused by DVAs. In this report, the authors present a unique case of a DVA that hemorrhaged spontaneously, rather than hemorrhaging into a venous infarction following DVA thrombosis as has been more commonly reported. Clinical presentation A 22-year-old previously healthy male presented to the emergency department with a severe headache, confusion, and progressive hemiparesis. A computed tomography (CT) scan demonstrated a spontaneous left parietal intraparenchymal hemorrhage (IPH), with intraventricular extension and acute hydrocephalus. CT angiography did not demonstrate an underlying vascular malformation. The patient was taken emergently to the operating room for a left parietal craniotomy for evacuation of the hematoma. Intraoperative pathology was consistent with a DVA Postoperative magnetic resonance imaging (MRI), magnetic resonance angiography (MRA), and magnetic resonance venography (MRV) did not demonstrate a mass lesion, ischemic stroke, or underlying vascular malformation. An MRI obtained three years previously for headaches was normal. A postoperative diagnostic cerebral angiogram was normal. An MRI/MRA performed six months postoperatively demonstrated two foci of abnormal vessels on susceptibility-weighted imaging (SWI), suggesting the presence of a venous vascular malformation. A diagnostic cerebral angiogram obtained six months postoperatively was again normal, including delayed imaging. Conclusion Few reports have cited DVA as the sole cause of intracerebral hemorrhage. While very rare, these reports suggest hemorrhagic conversion of a venous infarction secondary to a thrombosed DVA as a possible etiology, and several provide imaging consistent with this diagnosis. This case study demonstrates a unique presentation of a hemorrhagic DVA in the absence of thrombosis or stroke.

scholarly journals Orbital Lymphatic-Venous Malformation Accompanied by an Intraocular Vascular Malformation: A Rare Case Study

2021 ◽  
pp. 396-401
Author(s):  
Karny Shouchane-Blum ◽  
Iftach Yassur ◽  
Amir Sternfeld ◽  
Miriam Regev ◽  
Orly Gal-Or ◽  
...  
Keyword(s):  
Vascular Malformation ◽  
Rare Case ◽  
Vascular Malformations ◽  
Venous Malformation ◽  
Female Infant ◽  
Venous Malformations ◽  
Venous Anomalies ◽  
Developmental Venous Anomalies ◽  
The Right

Lymphatic-venous malformations (LVMs) are development defects that result in abnormal connections between the lymphatic and venous systems. The authors describe a 7-weeks-old female infant who presented with a right orbital LVM extending to the ipsilateral cheek and subconjunctiva of the right eye, intracranial developmental venous anomalies in the right cerebellum, and a significant right eye intraocular retinal vascular malformation. Since orbital LVM is usually diagnosed in infancy or childhood, pediatric ophthalmologists should actively look for intraocular vascular malformations as such findings can poorly affect a patient’s vision.

Case Study of a Rare Incidence of a Leiomyosarcoma Mass Occluding the Distal Femoral Vein

2021 ◽  
pp. 875647932110440
Author(s):  
Tammy Perkins ◽  
Kelly McDonald ◽  
Douglas Clem
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Lower Extremity ◽  
Femoral Artery ◽  
Femoral Vein ◽  
Lower Leg ◽  
Resonance Imaging ◽  
Computed Tomographic ◽  
Magnetic Resonance Imaging Mri

This is a case study of a 47-year-old Caucasian male whose chief concern was left lower leg swelling for 1 month. A unilateral lower extremity venous duplex examination was performed. The results concluded that the distal femoral vein was occluded to the distal popliteal vein. Incidentally, a hypoechoic region in the distal thigh near the distal femoral artery was noted by the technologist. The patient was placed on anticoagulation and was told to return for further examination if there was no relief. Three months later, the patient continued to experience lower left leg swelling and returned for another sonogram. The hypoechoic region was seen again in the distal thigh and remained occluded. A computed tomographic arterial (CT-A) and magnetic resonance imaging (MRI) were ordered for further investigation of the hypoechoic area. The CT-A and the MRI revealed the presence of a mass in the distal thigh. The mass was biopsied and diagnosed as a leiomyosarcoma, grade 1. The mass caused the compression and occlusion of the distal femoral vein. The mass was removed, along with a portion of the distal femoral artery due to involvement of the artery within the mass. The artery was repaired with a graft.

Venous-predominant parenchymal arteriovenous malformation: a rare subtype with a venous drainage pattern mimicking developmental venous anomaly

2008 ◽  
Vol 108 (6) ◽  
pp. 1142-1147 ◽  
Author(s):  
So-Hyang Im ◽  
Moon Hee Han ◽  
Bae Ju Kwon ◽  
Jung Yong Ahn ◽  
Cheolkyu Jung ◽  
...  
Keyword(s):  
Arteriovenous Malformation ◽  
Vascular Malformation ◽  
Vascular Malformations ◽  
Gamma Knife Radiosurgery ◽  
Vascular Lesions ◽  
Arterial Phase ◽  
Developmental Venous Anomaly ◽  
Venous Anomaly ◽  
Arteriovenous Shunts

Object Considerable confusion exists in the literature regarding the classification of cerebrovascular malformations and their clinical significance. One example is provided by the atypical developmental venous anomaly (DVA) with arteriovenous shunt, because it remains controversial whether these lesions should be classified as DVAs or as atypical cases of other subtypes of cerebrovascular malformations. The purpose of this study was to clarify the classification of these challenging vascular lesions in an effort to suggest an appropriate diagnosis and management strategy. Methods The authors present a series of 15 patients with intracranial vascular malformations that were angiographically classified as atypical DVAs with arteriovenous shunts. This type of vascular malformation shows a fine arterial blush without a distinct nidus and early filling of dilated medullary veins that drain these arterial components during the arterial phase on angiography. Those prominent medullary veins converge toward an enlarged main draining vein, which together form the caput medusae appearance of a typical DVA. Results Based on clinical, angiographic, surgical, and histological findings, the authors propose classifying these vascular malformations as a subtype of an arteriovenous malformation (AVM), rather than as a variant of DVA or as a combined vascular malformation. Conclusions Correct recognition of this AVM subtype is required for its proper management, and its clinical behavior appears to follow that of a typical AVM. Gamma Knife radiosurgery appears to be a good alternative to resection, although long-term follow-up results require verification.

External beam radiotherapy in the treatment of extensive vascular malformation of the lower extremity refractory to surgery and interventional embolisation therapy

2009 ◽  
Vol 8 (3) ◽  
pp. 157-162
Author(s):  
Mark Trombetta ◽  
Jonathan Potts ◽  
Vladimir Valakh ◽  
E. Day Werts ◽  
Elmer Nahum ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Vascular Malformation ◽  
Vascular Malformations ◽  
External Beam Radiotherapy ◽  
External Beam ◽  
Viable Option ◽  
Patient Case

AbstractThis patient case-study represents the introduction of radiotherapy in the management of extra-cranial vascular malformations, a topic with virtually no supported literature before our case study. In those patients refractory to established therapies and facing the inevitability of mutilating amputation, radiotherapy may be a viable option to preserve the limb.

scholarly journals Prevalence of Nonlesional Focal Epilepsy in an Adult Epilepsy Clinic

2013 ◽  
Vol 40 (2) ◽  
pp. 198-202 ◽  
Author(s):  
Dang Khoa Nguyen ◽  
Manuela Temgoua Mbacfou ◽  
Dong Bach Nguyen ◽  
Maryse Lassonde
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Focal Epilepsy ◽  
Vascular Malformations ◽  
Cortical Development ◽  
Hippocampal Atrophy ◽  
Imaging Data ◽  
Malformations Of Cortical Development ◽  
Resonance Imaging ◽  
Magnetic Resonance Imaging Mri

Purpose:To evaluate the prevalence of nonlesional focal epilepsy in an adult epilepsy clinic and its refractoriness to antiepileptic drug therapy.Background:Focal epilepsy is frequently, but not always, associated with structural epileptogenic lesions identifiable on magnetic resonance imaging (MRI).Methods:We analyzed the data from all patients evaluated at an adult epilepsy clinic from January 2002 to December 2011. Clinical and paraclinical findings were used to diagnose focal epilepsy. Magnetic resonance imaging were reviewed and classified as normal, with an epileptogenic lesion, or with a lesion of unclear epileptogenicity. Epileptogenic lesions were further categorized as tumours, vascular malformations, gliosis (including hippocampal atrophy/sclerosis), and malformations of cortical development. Our study group included patients with no lesions on MRI. Pharmacoresistance of patients with nonlesional focal epilepsy was assessed using the ILAE and Perucca's criterias.Results:Out of 1521 patients evaluated (mean age 44 years; range 14-93 years), 843 had focal epilepsy. Magnetic resonance imaging data, available for 806 (96%) subjects, showed epileptogenic lesions in 65%, no obvious epileptogenic lesions in 31% and lesions of unclear epileptogenicity in 4%. Magnetic resonance imaging-identified lesions included gliosis due to an acquired insult (52% including 17% of hippocampal atrophy or sclerosis), tumours (29%), vascular malformations (16%) and malformations of cortical development (10%). Fifty-two percent of nonlesional focal epileptic patients were drug-refractory.Conclusion:In a tertiary epilepsy clinic, close to a third of patients with focal epilepsy were found to be nonlesional, half of which were drug-resistant.

Spontaneous regression of a symptomatic developmental venous anomaly with capillary stain

2021 ◽  
pp. 159101992110324
Author(s):  
Takeru Hirata ◽  
Satoru Miyawaki ◽  
Satoshi Koizumi ◽  
Yu Teranishi ◽  
Osamu Ishikawa ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Contrast Enhancement ◽  
Spontaneous Regression ◽  
Precentral Gyrus ◽  
Developmental Venous Anomaly ◽  
Venous Anomaly ◽  
Resonance Imaging ◽  
Venous Anomalies ◽  
Developmental Venous Anomalies

Background Developmental venous anomalies are considered benign lesions; however, they can become symptomatic. A capillary stain, which is an atypical angiographical feature of developmental venous anomalies, is reported to be relevant to symptomatic developmental venous anomalies. Case description A 20-year-old man with no pertinent medical history had an epileptic seizure. Magnetic resonance imaging showed severe focal oedema and gadolinium contrast enhancement in the right precentral gyrus and inferior frontal gyrus adjacent to the Sylvian fissure, indicating venous congestion; these presentations had not been observed on magnetic resonance imaging 8 months before. Digital subtraction angiography revealed a developmental venous anomaly with capillary stain. After conservative treatment, the brain oedema resolved spontaneously and contrast enhancement of the lesion reduced significantly. Conclusion We report a rare case of a symptomatic developmental venous anomaly with unique radiological characteristics and its natural and clinical evolution. Despite the presence of a capillary stain, our patient exhibited temporary exacerbations and spontaneous regression, suggesting that the capillary stain was associated with a reversible condition. This is the first report to detail the spatiotemporal changes of a developmental venous anomaly with capillary stain through imaging, suggesting that regular follow-up imaging is warranted in the management of patients with developmental venous anomalies.

scholarly journals The contribution of susceptibility-weighted imaging (SWI) in the central nervous system superficial siderosis’ evaluation in 3 Tesla magnetic resonance imaging (MRI)

2021 ◽  
Vol 20 (3) ◽  
pp. 324-329
Author(s):  
Bünyamin Güney ◽  
◽  
İbrahim Önder Yeniçeri ◽  
Emrah Doğan ◽  
Neşat Çullu ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Vascular Malformation ◽  
3 Tesla ◽  
Superficial Siderosis ◽  
Susceptibility Weighted Imaging ◽  
Amyloid Angiopathy ◽  
Resonance Imaging ◽  
Significant Difference ◽  
Magnetic Resonance Imaging Mri

Objective. The aim of this study is to evaluate the magnetic resonance imaging (MRI) findings of central neural system (CNS) superficial siderosis cases and the diagnostic contribution of the susceptibility-weighted imaging (SWI) sequence to conventional imaging. Method. TSE T2-weighted and SWI-MRI of 26 patients diagnosed as CNS-superficial siderosis (CNS-SS) were retrospectively evaluated with 3-Tesla MRI. The localization and type of involvement of SS were reviewed. Results. The CNS-SS were divided into two categories as central amyloid angiopathy-SS (CAA-SS) and non central amyloid angiopathy-SS (non-CAA-SS). In non-CAA cases, the involvement was typical (classic) in 5 cases and atypical in 9 cases. In 12 of these cases (85.7%), SS findings were observed on both turbo spine echo (TSE) T2 images and SWI imaging, while in 2 cases (14.3%) SS was detected only on SWI images. In 7 of the CAA-SS cases, involvement was focal type SS (58.33%), while 5 cases had diffuse type SS (41.67%) involvement. In the vast majority of cases (n = 10) of this type of SS, involvement was detected only in SWI images, while siderosis was not detected in TSE T2 images. In addition, occult cerebral vascular malformation accompanying SS, which can be observed only in the SWI sequence, was found in a total of 4 cases. In the cross-matching statistical analysis performed between CAA-SS and non-CAA-SS groups and subgroups, SWI was found to be significantly superior to T2 in detecting SS in the CAA-SS group (p:0,007). Conclusions. SWI imaging was superior in detecting SS and detecting cerebral occult vascular malformation in CAA-SS cases. Although the detectability of SS by SWI was high in other groups, no statistically significant difference was found. Under these circumstances, we think that it will be beneficial to add SWI imaging to the routine imaging protocol in cases with suspected CNS-SS.

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