Zusammenfassung
Als eine embryologische Variante der venösen Drainage macht die so genannte „developmental venous anomaly“ (DVA) etwa 60% aller zerebralen vaskulären Malformationen aus. Der vormalige Terminus „venöses Angiom“ sollte nicht mehr benutzt werden, da er abnormale Gefäßstrukturen mit einem erhöhten Blutungsrisiko impliziert. Die DVA werden oft inzidentell entdeckt und sind nur selten symptomatisch. Das typische Erscheinungsbild ist durch dilatierte, medusenhauptartig angeordnete venöse Marklagergefäße gekennzeichnet, die in eine größere Sammelvene drainieren. Der Abfluss erfolgt über das oberflächliche oder tiefe Venensystem. Klinisch wichtig ist die häufige Assoziation mit anderen zerebralen Gefäßmalformationen, insbesondere kavernösen Angiomen, nach denen im Rahmen der Diagnostik explizit gesucht werden muss, da diese eine potenzielle Blutungsquelle darstellen und ein therapeutisches Vorgehen erfordern können.
Abstract
As congenital anatomic variants of venous drainage, developmental venous anomalies (DVA) represent up to 60% of all cerebral vascular malformations. The prior term “venous angioma” is a misnomer implicating an abnormal vascular structure with an increased bleeding risk. They are often found incidentally and are hardly ever symptomatic. Their morphologic characteristics are dilated vessels in the white matter, which converge on a greater collector vein, forming the typical caput medusae. They drain into the superficial or deep venous system. The frequent association with other, potentially bleeding-prone vascular malformations is clinically relevant, in particular cavernous angioma, which might require therapeutic action. Therefore, coincident vascular lesions need to be actively sought by appropriate additional imaging techniques.
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Zimmer, A., Hagen, T., Ahlhelm, F. et al. Developmental Venous Anomaly (DVA). Radiologe 47, 868–874 (2007). https://doi.org/10.1007/s00117-007-1528-2
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DOI: https://doi.org/10.1007/s00117-007-1528-2