UNUSUAL PATTERN OF A DEEP DEVELOPMENTAL VENOUS ANOMALY ON CT AND MR STUDIES

Objective: This article focuses on an unusual cross-sectional imaging pattern of a deep developmental venous anomaly (DVA). Since these anom alies are nonpathologic, they must not be interpreted as a disease tha t requires further costly workup and potentially injurious procedures (cerebral angiography). Materials and Methods: Two women aged 19 (Case 1) and 30 (Case 2) years sought medical evaluation for severe headach es. Both patients underwent CT, MRI, and conventional cerebral angiogr aphy. Case 1 also underwent MR venography. Results: The diagnosis of a n unusual DVA in Case 1 was confirmed only after conventional catheter angiography and a follow-up MR venogram. In Case 2 the diagnosis was inferred based upon the CT, MRI, and conventional angiography results and the marked similarity to Case 1. The presumptive diagnosis in Case 2 would not have been made with confidence without the prior experien ce of managing Case 1. Conclusion: DVAs (venous angiomas) are extreme variations in the pattern of intracranial venous drainage. These two c ase reports highlight an unusual pattern of this benign entity. Indivi duals interpreting cross-sectional imaging studies should be cognizant of this pattern.