| Pathomechanisms of symptomatic developmental venous anomalies. | |
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MedLine Citation:
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PMID: 18988912 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND AND PURPOSE: Although it is generally accepted that developmental venous anomalies (DVAs) are benign vascular malformations, over the past years, we have seen patients with symptomatic DVAs. Therefore, we performed a retrospective study and a literature study to review how, when, and why DVAs can become clinically significant. METHODS: Charts and angiographic films of 17 patients with DVAs whose 18 vascular symptoms could be attributed to a DVA were selected from a neurovascular databank of our hospital. MRI had to be available to rule out any other associated disease. In the literature, 51 cases of well-documented symptomatic DVAs were found. Pathomechanisms were divided into mechanical and flow-related causes. RESULTS: Mechanical (obstructive or compressive) pathomechanisms accounted for 14 of 69 symptomatic patients resulting in hydrocephalus or nerve compression syndromes. Flow-related pathomechanisms (49 of 69 patients) could be subdivided into complications resulting from an increase of flow into the DVA (owing to an arteriovenous shunt using the DVA as the drainage route; n=19) or a decrease of outflow (n=26) or a remote shunt with increased venous pressure (n=4) leading to symptoms of venous congestion. In 6 cases, no specific pathomechanisms were detected. CONCLUSIONS: Although DVAs should be considered benign, under rare circumstances, they can be symptomatic. DVAs, as extreme variations of normal venous drainage, may represent a more fragile venous drainage system that can be more easily affected by in- and outflow alterations. The integrity of the DVA needs to be preserved irrespective of the treatment that should be tailored to the specific pathomechanism. |
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Authors:
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Vitor M Pereira; Sasikhan Geibprasert; Timo Krings; Thaweesak Aurboonyawat; Augustin Ozanne; Frederique Toulgoat; Sirintara Pongpech; Pierre L Lasjaunias |
Publication Detail:
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Type: Journal Article Date: 2008-11-06 |
Journal Detail:
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Title: Stroke; a journal of cerebral circulation Volume: 39 ISSN: 1524-4628 ISO Abbreviation: Stroke Publication Date: 2008 Dec |
Date Detail:
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Created Date: 2008-11-25 Completed Date: 2009-01-06 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0235266 Medline TA: Stroke Country: United States |
Other Details:
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Languages: eng Pagination: 3201-15 Citation Subset: IM |
Affiliation:
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Service de Neuroradiologie Diagnostique et Thérapeutique, Hôpital de Bicêtre, Le Kremlin-Bicêtre, Paris, France. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Arteriovenous Fistula / etiology Blood Pressure Central Nervous System Venous Angioma / complications, physiopathology*, therapy Child Child, Preschool Embolization, Therapeutic Female Hemorheology Humans Hydrocephalus / etiology Infant Infant, Newborn Intracranial Arteriovenous Malformations / complications, physiopathology Male Middle Aged Nerve Compression Syndromes / etiology Paresis / etiology Radiosurgery Seizures / etiology Stress, Mechanical Stroke / etiology |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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