Cerebral Cavernous Malformation Associated Developmental Venous Anomaly
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A cerebral cavernous malformation (CCM) associated with a developmental venous anomaly (DVA) refers to the coexistence of two distinct cerebral vascular malformations.
🧠 Cerebral Cavernous Malformation (CCM)
- Cluster of abnormally dilated, thin-walled capillaries.
- Lacks intervening normal brain parenchyma.
- Low-flow lesion with risk of microhemorrhages or overt bleeding.
- Clinical presentations:
- Seizures
- Focal neurological deficits
- Incidental finding on MRI
💧 Developmental Venous Anomaly (DVA)
- Most common type of cerebral vascular malformation.
- Characterized by radially arranged medullary veins draining into a central trunk.
- Typically benign and asymptomatic.
- Found incidentally in most cases.
🔗 Association Between CCM and DVA
- Up to 20–30% of CCMs are associated with a DVA.
- Hemodynamic stress from the DVA may contribute to CCM formation or hemorrhage.
- Surgical relevance: DVAs drain normal brain tissue → must not be resected during cavernoma surgery.
Diagnosis
🛑 Clinical Note
Surgical planning must preserve the DVA to prevent venous infarction. Only the cavernoma should be targeted for resection if symptomatic.