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Case Reports
. 2022 Jun;35(3):399-402.
doi: 10.1177/19714009211042883. Epub 2021 Aug 31.

Unique enlarging cavernous malformation secondary to abnormal arteriovenous shunting through an associated developmental venous anomaly

Nimisha Parikh  1 , Richard Williamson  1 , Matthew Kulzer  1 , Albert Sohn  1 , Warren M Chang  1 , Charles Q Li  1
Affiliations
Case Reports

Unique enlarging cavernous malformation secondary to abnormal arteriovenous shunting through an associated developmental venous anomaly

Nimisha Parikh et al. Neuroradiol J. 2022 Jun.

Abstract

Cavernous malformations are angiographically occult vascular malformations. They are often associated with a developmental venous anomaly through poorly understood mechanisms. We present an unusual case of a gradually enlarging cavernous malformation associated with a developmental venous anomaly with arteriovenous shunting, suggesting venous hypertension or reflux as a potential cause of progressive growth.

Keywords: Cavernoma; cavernous malformation; developmental venous anomaly; vascular malformations.

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Conflict of interest statement

Conflict of interest: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Initial axial non-contrast head computed tomography (CT) demonstrates a 1 cm hyperattenuating intra-axial lesion (a) centered on the right putamen with minimal local mass effect. Axial T2-weighted (b), susceptibility-weighted (c), and T1-weighted post-contrast (d) magnetic resonance (MR) images demonstrate a heterogeneously T2 hyperintense lesion with chronic internal and peripheral blood products and faint enhancement. Superiorly, a network of fine enhancing vessels are seen coalescing into a larger trunk traversing the superior frontal sulcus draining into a superior frontal convexity cortical vein ((e) and (f)).
Figure 2.
Figure 2.
Serial axial T2-weighted magnetic resonance (MR) images show gradual enlargement of the cavernous malformation (CM) over 3 years. Initial (a), 15-month (b), 22-month (c), and 27-month (d) time-points.
Figure 3.
Figure 3.
Axial T1 (a), T1-post-contrast (b) and T2-weighted (c) images at the last time-point demonstrate a large heterogeneously enhancing mass centered on the right putamen. Axial susceptibility weighted image (d) demonstrates chronic internal and peripheral blood products.
Figure 4.
Figure 4.
Lateral Digital Subtraction Angiography (DSA) images in the early arterial (a) and late arterial phases (b) showing a small vascular malformation (arrow) supplied by the right anterior cerebral artery and early drainage via the developmental venous anomaly (DVA) trunk (arrow), demonstrating arteriovenous shunting of the DVA.
See this image and copyright information in PMC

References

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