Abstract
Background
Developmental venous anomalies (DVAs) are the most common intracranial vascular malformations of the brain. They are most commonly asymptomatic and often diagnosed incidentally.
Illustrative case
We present a rare case of a 9-year-old boy with seizures caused by a subcortically located DVA posterior to the postcentral gyrus of the left brain hemisphere. MRI also showed an enlarged, microcystically altered pineal gland and an extracranial cavernous hemangioma. EEG showed left fronto-centro-parietal spikes that corresponded with the location of the DVA. The spikes were occasionally secondary generalized. The boy responded well to oxcarbazepine treatment, and no surgical intervention was required. Control MRI scans showed no progression of the DVA.
Conclusion
Epilepsy may be caused by DVA. The treatment starts with anticonvulsants. The surgical treatment is the therapeutic choice only if seizures are resistant to conservative therapy because surgery might result in serious ischemic or hemorrhagic complications because DVAs are considered to be variations of normal transmedullary veins that are necessary for the drainage of white and gray matter.
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References
Rammos SK, Maina R, Lanzino G (2009) Developmental venous anomalies: current concepts and implications for management. Neurosurgery 65(1):20–30. doi:10.1227/01.NEU.0000347091.06694.3E
Töpper R, Jürgens E, Reul J, Thron A (1999) Clinical significance of intracranial developmental venous anomalies. J Neurol Neurosurg Psychiatry 67:234–238. doi:10.1136/jnnp.67.2.234
Koc K, Anik I, Akansel Q, Anik Y, Ceylan S (2007) Massive intracerebral haemorrage due to developmental venous anomaly. Br J Neurosurg 21:403–405. doi:10.1080/02688690701468707
Enslin J, Lefeuvre D, Taylor A (2013) Developmental venous anomaly with contralateral impaired venous drainage in a 17-year-old male a case report. Interv Neuroradiol 19:67–72
Viera Santos A, Saraiva P (2006) Spontaneous isolated non-haemorrhagic thrombosis in a child with development venous anomaly: case report and review of the literature. Childs Nerv Syst 22:1631–1633. doi:10.1007/s00381-006-0159-7
Lee M, Kim MS (2012) Image findings in brain developmental venous anomalies. J Cerebrovasc Endovasc Neurosurg 14(1):37–43. doi:10.7461/jcen.2012.14.1.37
Cohen JE, Boitsova S, Moscovici S, Itshayek E (2010) Concepts and controversies in the management of cerebral developmental venous anomalies. Isr Med Assoc J 12(11):703–706
Bošnjak J, Budišić M, Ažman D, Strineka M, Crnjaković M, Demarin V (2009) Pineal gland cysts—an overview. Acta Clin Croat 48(3):355–358
Hajnšek S, Paladino J, Petelin Gadže Z, Nanković S, Mrak G, Lupret V (2013) Clinical and neurophysiological changes in patients with pineal region expansions. Coll Antropol 37(1):35–40
Striano S, Nocerino C, Striano P et al (2000) Venous angiomas and epilepsy. Neurol Sci 21:151–155. doi:10.1007/s100720070090
Morioka T, Hashiguchi K, Nagata S et al (2006) Epileptogenicity of supratentorial medullary venous malformation. Epilepsia 47:365–370. doi:10.1111/j.1528-1167.2006.00429.x
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Andrea, Š.K., Jakov, M. & Nikola, G. Epilepsy in a boy with a developmental venous anomaly—case-based update. Childs Nerv Syst 31, 843–846 (2015). https://doi.org/10.1007/s00381-015-2663-0
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DOI: https://doi.org/10.1007/s00381-015-2663-0