Hosting 728 files, 2951 images, and 4 contributors.

Random Case

Partial Testicular Torsion
Joseph Junewick, MD FACR
over 9 years ago
Enter A Workflow
Standard2   Academic2

Please choose a workflow. A standard workflow allows you to browse the repository with full case detail; the academic workflow allows you to browse the repository with limited case detail revealed. Double click on the images to launch image viewer.

ARSt Case Repository

Developmental Venous Anomaly

Case Detail

Anatomy: Brain-Spine
Joseph Junewick, MD FACR
Diagnostic Category: Developmental or Congenital
Created: over 10 years ago
Updated: over 10 years ago
Tags: PEDS
Modality/Study Types: MR
Adobe32 PDF Imagej32 ImageJA


Teenager with headache.

Case Images


Developmental Venous Anomaly


Developmental venous anomalies (DVA) represent extreme variations of the normal transcerebral venous system. DVAs are asymptomatic in most cases; occasionally venous ischemia or infarctions may occur if the outflow is compromised. DVAs are believed to be adaptations from occlusion or maldevelopment of either the superficial or deep veins during development, resulting in establishment of collateral drainage pathways.

At CT and MR imaging, the main draining vein can be identified as a linear or curvilinear enhancing structure or flow void. Enhancement of the dilated medullary veins (“caput medusae”) can also be observed. The classic angiographic feature is the caput medusae (or “inverse umbrella”) appearance of the transmedullary veins seen only in the venous phase. A dense capillary stain can be seen in larger lesions; however, the lack of arterial enlargement suggests a DVA.

Occasionally, signal abnormalities may be seen adjacent to DVAs on standard MR sequences. The etiology of the signal intensity is uncertain but may be related to edema or gliosis related to venous stenosis or altered hemodynamics. Ischemic or demyelinating disease in the drainage area of the DVA may also contribute.


Geibprasert S, Pongpech S, Jiarakongmun P Shroff MM, et al. Radiologic Assessment of Brain Arteriovenous Malformations: What Clinicians Need to Know. Radiographics (2010); 30: 483-501.

Santuccia GM, Leacha JL, Yingd J, Tomisicka TA. Brain Parenchymal Signal Abnormalities Associated with Developmental Venous , Anomalies: Detailed MR Imaging Assessment. American Journal of Neuroradiology (2008); 29:1317-1323.

Corporate Office: 616.363.7272, 3264 North Evergreen Drive, Grand Rapids, MI 49525

Spectrum Health Helen Devos Childrens Hospital GE HealthCare