Clinical significance of intracranial developmental venous anomalies

Objectives-Venous angiomas, or developmental venous anomalies (DVAs), repre sent the most often occurring cerebral vascular malformation. The clinical significance of a DVA is, however, at present unclear. Methods-A retrospective analysis was carried out on two series of consecuti ve cranial MRIs performed between January 1990 and August 1996 in a univers ity department of neuroradiology and in a large radiological private practi ce. The medical records of all patients in whom a DVA was diagnosed were sc reened to identify the specific complaint which necessitated the imaging pr ocedure. Results-A total of 67 patients with DVA could be identified. In 12 patients an associated cavernoma was found. The main reason for performing the MRI: was the evaluation of seizures or of headaches. In all patients with DVA i n whom an intracerebral haemorrhage was diagnosed an associated cavernoma w as present at the site of the haemorrhage. None of the 67 patients showed a n association between the complaints that led to the MRI and the location o f the DVA. Conclusions-DVAs do not seem to be associated with a specific clinical pres entation. In a significant percentage of cases, however, coexisting caverno mas are found which have a defined bleeding potential and should be treated independently of the DVA. This study supports the hypothesis that DVAs are a congenital abnormality of venous drainage without clinical significance.