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Left cerebellar developmental venous anomaly (DVA), case 1

This 49 year old male presented with intermittent episodes of headache and balance disorders.
The initial contrast enhanced CT scan suggested the presence of a DVA in the left cerebellar hemisphere. Thereafter, he had both MRI-MRA and conventional catheter based cerebral angiography in order to confirm the presumed diagnosis. Although the diagnosis of the DVA was thought to be certain on the basis of MRA, as this case occurred at the beginning of our MRA experience, conventional angiography was performed to definitely rule out other vascular pathology.

(Cerebellar DVA, 0.5T)
Fig.1 Sagittal non-enhanced T1-weighted spin-echo images. Irregular hypointense structures (arrows) in the deep areas of the left cerebellar hemisphere.
Fig.2 Transverse proton density and T2-weighted fast spin-echo images. A curved vascular structure (transcerebellar collector) is clearly seen in the left cerebellar hemisphere. Note also the combination of pulsatile and oblique flow (spatial misregistration) artifacts (see Artifacts: Flow artifacts).
Fig.3 Transverse source images from a Gadolinium-enhanced 3D TOF acquisition. The caput medusae (yellow arrows) and the transcerebellar collector (blue arrows) are clearly seen. The DVA extends to the 4th ventricle and drains practically the whole left cerebellar hemisphere.
Fig.4 Coronal targeted MIP projections from the Gadolinium-enhanced 3D TOF acquisition.
Fig.5 Sagittal collapsed (above) and targeted (below) MIP images from the Gadolinium-enhanced 3D TOF acquisition.
Fig.6 Corresponding a-p and lateral views of the DVA by conventional, catheter based cerebral angiography (DSA) for comparison.

 

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Fig. 1

Left cerebellar developmental venous anomaly (DVA), case 1, Fig. 1
Left cerebellar developmental venous anomaly (DVA), case 1, Fig. 2
Left cerebellar developmental venous anomaly (DVA), case 1, Fig. 3
Left cerebellar developmental venous anomaly (DVA), case 1, Fig. 4
Left cerebellar developmental venous anomaly (DVA), case 1, Fig. 5
Left cerebellar developmental venous anomaly (DVA), case 1, Fig. 6