Document Detail


Pathomechanisms of symptomatic developmental venous anomalies.
MedLine Citation:
PMID:  18988912     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Vitor M Pereira; Sasikhan Geibprasert; Timo Krings; Thaweesak Aurboonyawat; Augustin Ozanne; Frederique Toulgoat; Sirintara Pongpech; Pierre L Lasjaunias
Publication Detail:
Type:  Journal Article     Date:  2008-11-06
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  39     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2008-11-25     Completed Date:  2009-01-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  United States    
Other Details:
Languages:  eng     Pagination:  3201-15     Citation Subset:  IM    
Affiliation:
Service de Neuroradiologie Diagnostique et Thérapeutique, Hôpital de Bicêtre, Le Kremlin-Bicêtre, Paris, France.
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MeSH Terms
Descriptor/Qualifier:
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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