Gelişimsel venöz anomali

Özet

Gelişimsel venöz anomali (DVA), normal beyin dokusunun medüller venöz kanını bir toplayıcı vene aktaran yaygın bir drenaj varyantıdır ve çoğunlukla tesadüfen saptanır. DVA'nın kendisi çoğu kez klinik sorun yaratmaz; komşu kanama, venöz enfarkt veya toplayıcı ven trombozu ayrıca araştırılmalıdır. Drenaj damarını kitle veya anormal yüksek akımlı şant sanmak gereksiz müdahaleye, tromboz ya da ilişkili kavernomu atlamak ise komplikasyonun nedenini kaçırmaya yol açar.

Okuma sırası

1. Derin medüller venler. Derin beyaz cevherde ince kontrastlı venleri arayın; venlerin ortak bir çıkışa doğru yelpaze gibi dizilmesi DVA'yı tanıtan örüntüdür.
2. Toplayıcı ven. Radiküllerin birleştiği kalın damarı kesitler boyunca izleyin ve kortikal vene, derin vene ya da dural sinüse ulaştığı yeri saptayın.
3. Venöz radiküller arası parankim. Venöz radiküller arasındaki parankimin korunmuş olması ve DVA'da arteriyel bileşen bulunmaması, DVA'yı AVM'den ayırmaya yardımcı olur.
4. DVA drenaj alanı ve toplayıcı ven. Drenaj alanında hipodens ödem, hematom veya belirgin hiperdens toplayıcı ven arayın; bu bulgular venöz enfarkt, kanama ya da tromboz komplikasyonunu gündeme getirir.

Faz ve pencere

Kontrastsız

Küçük DVA genellikle görünmez; büyük ve patent toplayıcı ven hafif hiperdens seçilebilir. Belirgin hiperdens toplayıcı ven tromboz kuşkusunu doğurur ve kontrastlı venöz incelemeyle açıklanmalıdır.

BTA tanısal

İnce kesitli venöz opasifikasyon/BT venografide beyaz cevherden gelen radyal ince venler kontrastlanarak tek bir lineer veya kıvrımlı toplayıcı vene birleşir; bu 'caput medusae' drenaj paternidir. Venöz faz opasifikasyonu yetersizse toplayıcı ven tam dolmaz ve DVA saptanamayabilir.

Önerilen pencereler: Anjiyo (G 600 / M 150), Beyin (G 80 / M 40).

BT bulguları

• Caput medusae görünümü — radyal medüller venler şemsiye biçiminde ortak bir toplayıcı vende birleşir.
• Toplayıcı ven — derin beyaz cevherden kortikal vene, derin vene veya dural sinüse uzanan lineer/kıvrımlı kontrastlı damar.
• Korunmuş aradaki parankim — damar radikülleri arasındaki beyin dokusu normal görünür; kitleleşme beklenmez.
• Arteriyel besleyici ve nidus yokluğu — tipik DVA yüksek akımlı arteriovenöz şanttan ayrılır.
• Toplayıcı ven lümeninde yoğunluk artışı — kontrastsız BT'de belirgin hiperdensite trombozu düşündürebilir.
• Drenaj alanında ödem veya hipodensite — venöz konjesyon ya da enfarkt olasılığını artırır.
• Komşu hematom — DVA ile birlikte bulunan kavernöz malformasyon veya venöz komplikasyon için ayrıca incelenir.

Normalde

Normal medüller venler tek tek BT'de belirginleşmez; kontrastlı venöz görüntüde kortikal venler ve dural sinüsler beklenen drenaj yolunda opasifiye olur. Şüpheli bölgede radyal venlerin parankimi bozmadan birleşip birleşmediğini, toplayıcı venin hangi sinüse veya derin vene ulaştığını ve karşı hemisferdeki venöz anatomiyle asimetriyi kıyaslayın.

Ayırıcı tanı

Arteriovenöz malformasyon

kontrastlı incelemede besleyici arter, nidus ve erken drene olan ven içeren şant kompleksi bulunur.

Serebral ven trombozu

sinüs veya kortikal ven dolum defekti, venöz drenaj alanında ödem ya da hemorajik enfarkt görülebilir.

Kavernöz malformasyon

MR görüntülerde hemosiderin kenarlı popkorn benzeri bir odak oluşturur; angiografik olarak sessizdir ve normal parankimi yok sayan daraltıcı kapiller yapılar içerir.

Gelişmiş kollateral venöz ağ

dural sinüs tıkanıklığı ya da venöz hipertansiyonla birlikte çok sayıda genişlemiş ven ve alternatif drenaj yolları görülür.

Kontrastlanmış kortikal damar

tek bir normal kortikal ven olabilir; medüller radyal kolların ortak toplayıcı vene birleşmesi DVA lehinedir.

Tuzaklar

• Venöz faz görüntülemesi yetersizse toplayıcı ven tam dolmaz; venöz opasifikasyonun yeterliliğini teyit etmeden DVA yok denilmemeli.
• Kontrastsız BT'deki hafif hiperdens toplayıcı veni otomatik olarak normal varyant saymayın; belirgin yoğunluk ve çevre ödem varsa tromboz araştırılmalıdır.
• DVA içindeki normal parankim görünümünü damar yumağıyla karıştırmayın; gerçek AVM'de nidus ve arteriyel beslenme beklenir.
• DVA yakınındaki akut kanamayı doğrudan DVA'ya atfetmeyin; eşlik eden kavernom veya venöz çıkış tıkanıklığı aranmalıdır.

Kendini dene

1. Venöz faz BT'de derin beyaz cevher venleri yelpaze biçiminde tek toplayıcı vene açılıyor. En olası yapı nedir?

   • Gelişimsel venöz anomali
   • Arteriovenöz malformasyon
   • Kavernöz malformasyon
   • Kortikal ven trombozu
   Cevabı göster

   Gelişimsel venöz anomali. Radyal medüller venlerin tek toplayıcıya birleşmesi DVA'nın tipik drenaj düzenidir. DVA'da radyal venler tek bir geniş venöz kanalda birleşir ve arteriyel bileşen bulunmaz; bu özellikler AVM'den ayrımını destekler.

2. DVA olarak bilinen toplayıcı ven kontrastsız BT'de belirgin hiperdens ve çevresinde ödem var. Hangi olasılık önceliklidir?

   • Toplayıcı ven trombozu
   • Rastlantısal patent DVA
   • Pontin telenjiektazi
   • Kalsifiye emboli
   Cevabı göster

   Toplayıcı ven trombozu. Belirgin hiperdens toplayıcı ven tromboz işareti olabilir; eşlik eden ödem venöz konjesyon veya enfarktı destekler. Patent DVA genellikle komplikasyonsuz drenaj varyantıdır; diğer seçenekler bu venöz bulguyu açıklamaz.

Kaynaklar

Bu sayfadaki 38 cümle ve 2 quiz sorusu aşağıdaki kaynaklardan alıntılarla tek tek karşılaştırıldı; 5 cümle bu karşılaştırmada düzeltildi (2026-10-08).

1. Developmental venous anomaly (DVA) mimicking thrombosed cerebral veinpmc.ncbi.nlm.nih.gov
2. Developmental venous anomalies.pubmed.ncbi.nlm.nih.gov
3. Symptomatic developmental venous anomalies.pubmed.ncbi.nlm.nih.gov
4. Vascular malformations of the brain.pubmed.ncbi.nlm.nih.gov
5. Cerebral capillary telangiectasias: a meta-analysis and review of the literature.pubmed.ncbi.nlm.nih.gov
6. Developmental venous anomalies of the brain in children -- imaging spectrum and update.pubmed.ncbi.nlm.nih.gov
7. Hemorrhage owing to cerebral cavernous malformation: imaging, clinical, and histopathological considerations.pubmed.ncbi.nlm.nih.gov
8. Epilepsy and cerebral developmental venous anomalies (DVAs): A systematic review.pubmed.ncbi.nlm.nih.gov
9. Extra-Axial Cavernoma of the Cerebellopontine Angle: A Case Study and Review of Literature.pubmed.ncbi.nlm.nih.gov
10. CNS cavernous haemangioma: "popcorn" in the brain and spinal cord.pubmed.ncbi.nlm.nih.gov
11. Symptomatic Developmental Venous Anomaly: State-of-the-Art Review on Genetics, Pathophysiology, and Imaging Approach to Diagnosis.pubmed.ncbi.nlm.nih.gov
12. Atypical Intracerebral Developmental Venous Anomalies in Sturge-Weber Syndrome: A Case Series and Review of Literature.pubmed.ncbi.nlm.nih.gov
13. De novo cavernous angiomas associated with developmental venous anomaly: a mini-series and literature review.pubmed.ncbi.nlm.nih.gov
14. Association of venous varix and developmental venous anomaly: report of a case and review of literature.pubmed.ncbi.nlm.nih.gov
15. Developmental venous anomalies and cerebral cavernous malformations: Partners in crime.pubmed.ncbi.nlm.nih.gov
16. Idiopathic Syringomyelia: A Systematic Scoping Review.pubmed.ncbi.nlm.nih.gov
17. Cerebral Venous Outflow Insufficiency: A Study on Symptoms and Venous Stenosis Classification.pubmed.ncbi.nlm.nih.gov
18. Incidental noninvasive diagnosis of isolated persistent left superior vena cava in asymptomatic adults: A case report.pubmed.ncbi.nlm.nih.gov
19. Postpartum Vertebral Artery Dissection After Neck Massage Resulting in a Right Cerebellar Infarct: A Case Report and Literature Review.pubmed.ncbi.nlm.nih.gov
20. Low-flow vascular malformations without arteriovenous shunting of the central nervous system: a pictorial review.pubmed.ncbi.nlm.nih.gov
21. PHACE syndrome: a systematic literature review and illustrative case report of a patient with severe cerebrovascular and neurodevelopmental sequelae.pubmed.ncbi.nlm.nih.gov
22. Developmental venous anomalies on fetal magnetic resonance imaging: prevalence and reproducible radiological phenotypes.pubmed.ncbi.nlm.nih.gov
23. Aeromedical decision-making for asymptomatic cerebral cavernous malformations in military pilots.pubmed.ncbi.nlm.nih.gov
24. Papillary thyroid carcinoma with coexisting venous hemangioma mimicking locally invasive disease: A case report.pubmed.ncbi.nlm.nih.gov
25. Posterior fossa Hodgkin's lymphoma radiographically mimicking an arteriovenous malformation: illustrative case.pubmed.ncbi.nlm.nih.gov
26. Cerebral cavernous malformation in a child leading to a fatal subarachnoid hemorrhage - "silent but sinister:" A case report and literature review.pubmed.ncbi.nlm.nih.gov
27. Spontaneous regression of an incidental brain venous aneurysm in a child and literature review.pubmed.ncbi.nlm.nih.gov
28. Neurocysticercosis and developmental venous anomaly in close proximity: a case report.pubmed.ncbi.nlm.nih.gov
29. Effectiveness of super-selective digital subtraction angiography and 3D rotational digital subtraction venography for a developmental venous anomaly with an arteriovenous malformation: A case report and literature review.pubmed.ncbi.nlm.nih.gov
30. New MR sequences in daily practice: susceptibility weighted imaging. A pictorial essay.pubmed.ncbi.nlm.nih.gov
31. Intracranial venous thrombosis imaging by anatomical location: an educational review with mimics and diagnostic pitfalls.pubmed.ncbi.nlm.nih.gov
32. Balloon-assisted retrograde cerebral venography for enhanced visualization of the posterior and lateral dural venous sinuses: a feasibility study.pubmed.ncbi.nlm.nih.gov
33. Imaging features, diagnosis, and clinical management of hepatic involvement in hereditary hemorrhagic telangiectasia: a case series report and literature review.pubmed.ncbi.nlm.nih.gov
34. Coexistence of a Hemispheric Developmental Venous Anomaly and Two Ipsilateral Arteriovenous Malformations: A Rare Neurovascular Association.pubmed.ncbi.nlm.nih.gov
35. Congenital Intracranial Vascular Malformations in Children : Radiological Overview.pubmed.ncbi.nlm.nih.gov
36. Vein of Galen Malformation-Experience of the Last 13 Years in a Reference Center from South-Eastern Europe.pubmed.ncbi.nlm.nih.gov
37. Clinical utility of BOLD fMRI in preoperative work-up of epilepsy.pubmed.ncbi.nlm.nih.gov
38. Long-term safety and effectiveness of the "OptEase" vena cava filter.pubmed.ncbi.nlm.nih.gov
39. Ruptured cerebral arteriovenous malformation associated with enlarged parietal foramina: a rare surgical case with pathogenetic implications.pubmed.ncbi.nlm.nih.gov
40. Cirrhosis-associated intracranial shunting lesions: illustrative case.pubmed.ncbi.nlm.nih.gov
41. De novo twig-like middle cerebral artery after suspected M1 dissection in early childhood with coexisting KRAS-mutated brain arteriovenous malformation: illustrative case.pubmed.ncbi.nlm.nih.gov
42. Developmental venous anomaly coexisting with arteriovenous malformation: a case report.pubmed.ncbi.nlm.nih.gov
43. Cerebellar cavernoma excision with a preserved venous anomaly: A case report in girl 28-year-old.pubmed.ncbi.nlm.nih.gov
44. Cerebral venous disorders: clinical presentation, diagnostic strategy, and contemporary management.pubmed.ncbi.nlm.nih.gov
45. Developmental venous anomaly related to de novo cerebral cavernous malformation: Imaging findings from two cases.pubmed.ncbi.nlm.nih.gov
46. Spontaneous hemorrhage of cavernous malformation in the region of the cochlear nucleus: A case report.pubmed.ncbi.nlm.nih.gov
47. Progression of a pontine cavernous malformation and delayed bilateral hypertrophic olivary degeneration: illustrative case.pubmed.ncbi.nlm.nih.gov
48. Selective Bridging Vein Embolization of a Transverse-Sigmoid Sinus Dural Arteriovenous Fistula Draining via the Jugular Foramen: A Case Report.pubmed.ncbi.nlm.nih.gov
49. Decreased Visibility of Deep Medullary Vein Associated with Cerebral Small Vessel Disease Burden through Increased Interstitial Fluid in White Matter.pubmed.ncbi.nlm.nih.gov
50. A Practical Approach to Intracranial Dural Arteriovenous Fistulas: Pathogenesis, Classification and Management.pubmed.ncbi.nlm.nih.gov
51. Prevalence of Developmental Venous Anomalies in Association with Sporadic Cavernous Malformations on 7T MRI.pubmed.ncbi.nlm.nih.gov
52. Vascular Malformations.pubmed.ncbi.nlm.nih.gov
53. Infantile Spasms (West Syndrome): Integrating Genetic, Neurotrophic, and Hormonal Mechanisms Toward Precision Therapy.pubmed.ncbi.nlm.nih.gov
54. Endovascular Embolization in Neurovascular Disease: Material Science, Multimodal Management, and Future Horizons.pubmed.ncbi.nlm.nih.gov
55. Arteriovenous Malformations (AVMs): Molecular Pathogenesis, Clinical Features, and Emerging Therapeutic Strategies.pubmed.ncbi.nlm.nih.gov
56. Perfusion imaging abnormalities in acute cerebral venous sinus thrombosis: A case series.pubmed.ncbi.nlm.nih.gov
57. Case Report: Structured MRI assessment of posterior thalamic infarction in a distribution compatible with posterior choroidal artery territory presenting as Déjerine-Roussy syndrome in an adolescent: differentiating arterial ischemia from venous thrombosis and thalamic neoplasm.pubmed.ncbi.nlm.nih.gov
58. Bilateral Thalamic Infarction Secondary to Deep Cerebral Venous Thrombosis: A Diagnostic Challenge Associated With Hormonal Therapy.pubmed.ncbi.nlm.nih.gov
59. Intraventricular giant cavernous malformation mimicking central neurocytoma characterized by digital subtraction angiography: illustrative case.pubmed.ncbi.nlm.nih.gov
60. Obstructive hydrocephalus secondary to an anterior mesencephalic cavernous malformation with familial cerebral cavernous malformation syndrome: A case report.pubmed.ncbi.nlm.nih.gov
61. Direct superior ophthalmic vein puncture for cavernous sinus dural arteriovenous fistula with dual orbital venous outflow: illustrative case.pubmed.ncbi.nlm.nih.gov
62. Treatment of iliac arteriovenous malformation associated with trisomy 21: a case report.pubmed.ncbi.nlm.nih.gov
63. Beyond the Usual Suspects: Rare Causes of Hemoptysis.pubmed.ncbi.nlm.nih.gov
64. Long-term outcomes in pediatric brain AVMs: beyond radiological cure.pubmed.ncbi.nlm.nih.gov
65. Dual-energy CT angiography in detecting underlying causes of intracerebral hemorrhage: an observational cohort study.pubmed.ncbi.nlm.nih.gov
66. Non-Thrombotic Filling Defects in Cerebral Veins and Sinuses: When Normal Structures Mimic a Disease.pubmed.ncbi.nlm.nih.gov
67. The accuracy of non-contrast brain CT scan in predicting the presence of a vascular etiology in patients with primary intracranial hemorrhage.pubmed.ncbi.nlm.nih.gov
68. Microsurgical obliteration of a superior petrosal dural arteriovenous fistula presenting with a symptomatic brainstem cavernous malformation.pubmed.ncbi.nlm.nih.gov
69. Comprehensive review of the cerebral aqueduct: anatomy, embryology, imaging, genetics, molecular, and pathology.pubmed.ncbi.nlm.nih.gov
70. Moyamoya Vasculopathy and Atypical Moyamoya-like Patterns: Insights into Diagnosis and Therapeutic Implications.pubmed.ncbi.nlm.nih.gov
71. Masses of developmental and genetic origin affecting the paediatric craniofacial skeleton.pubmed.ncbi.nlm.nih.gov
72. Twenty classic signs in neuroradiology: A pictorial essay.pubmed.ncbi.nlm.nih.gov
73. Lymphatic vessel: origin, heterogeneity, biological functions, and therapeutic targets.pubmed.ncbi.nlm.nih.gov
74. Role of Transcriptional and Epigenetic Regulation in Lymphatic Endothelial Cell Development.pubmed.ncbi.nlm.nih.gov
75. Meningeal Lymphatics in Central Nervous System Diseases.pubmed.ncbi.nlm.nih.gov
76. Combined surgical and interventional treatment of a giant superior vena cava aneurysm.pubmed.ncbi.nlm.nih.gov
77. Oculomotor Nerve Palsy Induced by a Cerebral Developmental Venous Anomaly: A Case Report and Comprehensive Review.pubmed.ncbi.nlm.nih.gov
78. Developmental Venous Anomaly: Benign or Not Benign.pubmed.ncbi.nlm.nih.gov
79. Cerebrovascular Malformations Associated With Hereditary Hemorrhagic Telangiectasia and HHT-Like Syndromes: A Comparative Overview.pubmed.ncbi.nlm.nih.gov
80. Controversies in Cavernous Malformation Management: A Comprehensive Review of Current Literature.pubmed.ncbi.nlm.nih.gov
81. Spontaneous Right Thalamic Hemorrhage With Intraventricular Extension in a Two-Month-Old Preterm Infant Initially Suspected of Having Cow's Milk Protein Allergy.pubmed.ncbi.nlm.nih.gov
82. Computed tomography of renal emergencies: A comprehensive diagnostic guide for radiology residents.pubmed.ncbi.nlm.nih.gov
83. Multimodal imaging of infantile scimitar syndrome with Eisenmenger physiology: A case report of complex intracardiac and extracardiac shunts.pubmed.ncbi.nlm.nih.gov
84. Identification of the Genomic Etiology of Unexplained Congenital Problems in Pediatric Patients: First Reported Case With Coffin-Siris Syndrome and Sialuria From India.pubmed.ncbi.nlm.nih.gov
85. Genome sequencing-based CNV analysis in an infant with concurrent partial trisomies 9p and 12p due to maternal translocation: A case report.pubmed.ncbi.nlm.nih.gov
86. Fused right S-shaped kidney incidentally detected on multidetector CT during staging of periampullary adenocarcinoma: A case report.pubmed.ncbi.nlm.nih.gov
87. Segmental Aplasia and Right Azygos Continuation of the Caudal Vena Cava in a Cat (Felis catus).pubmed.ncbi.nlm.nih.gov
88. Transvenous Embolization for Dural Arteriovenous Fistula through the Persistent Left Superior Vena Cava: A Case Report.pubmed.ncbi.nlm.nih.gov
89. Central nervous system vascular malformations: A clinical review.pubmed.ncbi.nlm.nih.gov
90. Direct Cerebral Revascularization: Extracranial-intracranial Bypass.pubmed.ncbi.nlm.nih.gov
91. Intracranial meningeal disease: comparison of contrast-enhanced MR imaging with fluid-attenuated inversion recovery and fat-suppressed T1-weighted sequences.pubmed.ncbi.nlm.nih.gov
92. Mastoid emissary vein, mastoid emissary foramen, and mastoid emissary canal: anatomy, variability, imaging, and clinical implications.pubmed.ncbi.nlm.nih.gov
93. A giant challenge: Hybrid management of a scalp and neck cirsoid aneurysm.pubmed.ncbi.nlm.nih.gov
94. A systematic approach to detection of epileptogenic foci on imaging: protocols, entities, search pattern, and reporting tools.pubmed.ncbi.nlm.nih.gov
95. Intracranial dural arteriovenous fistulas with and without pial arterial supply: a case series of 227 patients.pubmed.ncbi.nlm.nih.gov
96. Incidental Detection of a Posterior Inferior Cerebellar Artery (PICA)-Terminating Vertebral Artery Variant During CT Evaluation of Venous Sinus Thrombosis: A Case Report.pubmed.ncbi.nlm.nih.gov
97. Patterns of injury and violence in Yaoundé Cameroon: an analysis of hospital data.pubmed.ncbi.nlm.nih.gov
98. Non-Invasive Retinal Vessel Analysis as a Predictor for Cardiovascular Disease.pubmed.ncbi.nlm.nih.gov
99. A proposed framework for cerebral venous congestion.pubmed.ncbi.nlm.nih.gov
100. Spontaneous bacteremia and spontaneous bacterial peritonitis share similar prognosis in patients with cirrhosis: a cohort study.pubmed.ncbi.nlm.nih.gov
101. Conduction Aphasia in a Case of Left Cortical Veins and Left Lateral Sinus Thrombosis Due to Multiple Risk Factors: A Case Report and Review of the Literature.pubmed.ncbi.nlm.nih.gov
102. Morphological variations of the dural venous sinuses: a cadaveric study.pubmed.ncbi.nlm.nih.gov
103. Hemodynamic and developmental biomarkers enhance prenatal coarctation prediction: a validated multiparametric ultrasound model.pubmed.ncbi.nlm.nih.gov
104. Pathogenesis and Surgical Treatment of Dextro-Transposition of the Great Arteries (D-TGA): Part II.pubmed.ncbi.nlm.nih.gov
105. Paediatric cranial ultrasound: abnormalities of the brain in term neonates and young infants.pubmed.ncbi.nlm.nih.gov
106. Review of imaging modalities and radiological findings of calvarial lesions.pubmed.ncbi.nlm.nih.gov
107. Phakomatoses: A pictorial review.pubmed.ncbi.nlm.nih.gov
108. Pitfall in necrotizing pancreatitis: Organized hematoma with arteriovenous fistula mimicking a splenic artery pseudoaneurysm.pubmed.ncbi.nlm.nih.gov
109. From imaging to impact: A case of renal arteriovenous malformation.pubmed.ncbi.nlm.nih.gov
110. Balloon-Assisted Squid 12 Embolization of a Renal Angiomyolipoma With Imaging Findings Suggestive of Arteriovenous Communication: A Technical Report.pubmed.ncbi.nlm.nih.gov
111. Clinical management of isolated transverse-sigmoid sinus dural arteriovenous fistulas: a three-case illustrative series and narrative review.pubmed.ncbi.nlm.nih.gov

Eğitim amaçlıdır; hasta başında tanı ve tedavi kararının yerine geçmez. İçerik yapay zekâ destekli bir süreçle güncel literatüre göre cümle cümle kaynaklarla karşılaştırıldı, ancak uzman radyolog incelemesinden geçmedi. Klinik kararlarda güncel kılavuzları, kurum protokollerini ve radyoloji raporunu esas alın.