SEARCH

SEARCH BY CITATION

Additional Supporting Information may be found in the online version of this article.

FilenameFormatSizeDescription
ANA_21754_sm_SupFig4.tif171KFig 4 (online only). Sagittal Gd-3D-T1-weighted MR image showing a stenosis (white arrow) of the distal portion of a collecting vein of a frontoparietal DVA as it crosses the dura mater to enter the superior sagittal sinus.
ANA_21754_sm_SupFig6a.tif447KFig 6 (online only). A 9-year-old boy developed sudden onset of headache with nausea and vomiting. Imaging studies demonstrated a right cerebellar DVA associated with CM in its drainage territory as well as acute hemorrhage of the CM, (A) DSA, anterior-posterior (AP) projection, right vertebral artery injection, venous phase showing the right cerebellar DVA draining into the torcular herophili through an inferior vermian vein (arrow). No evidence of collecting vein stenosis was found. (B) Caput medusae (arrowheads); fast spin-echo (FSE) T2-weighted, axial image showing a CM (single arrow), surrounded by an area of subacute hemorrhage (arrowheads). The collecting vein of the DVA is seen as a flow void (double arrows) and drains into an enlarged inferior vermian vein (double arrowhead). There is perilesional edema in keeping with the subacute hemorrhage. (C) Gadolinium-enhanced gradient-echo (GE) T1, axial image at the same level as (B). The subacute hemorrhage appears hyperintense (arrowheads). There is enhancement of the DVA collecting vein (double arrow) and the inferior vermian vein (double arrowheads).
ANA_21754_sm_SupFig6b.tif352KFig 6 (online only). A 9-year-old boy developed sudden onset of headache with nausea and vomiting. Imaging studies demonstrated a right cerebellar DVA associated with CM in its drainage territory as well as acute hemorrhage of the CM, (A) DSA, anterior-posterior (AP) projection, right vertebral artery injection, venous phase showing the right cerebellar DVA draining into the torcular herophili through an inferior vermian vein (arrow). No evidence of collecting vein stenosis was found. (B) Caput medusae (arrowheads); fast spin-echo (FSE) T2-weighted, axial image showing a CM (single arrow), surrounded by an area of subacute hemorrhage (arrowheads). The collecting vein of the DVA is seen as a flow void (double arrows) and drains into an enlarged inferior vermian vein (double arrowhead). There is perilesional edema in keeping with the subacute hemorrhage. (C) Gadolinium-enhanced gradient-echo (GE) T1, axial image at the same level as (B). The subacute hemorrhage appears hyperintense (arrowheads). There is enhancement of the DVA collecting vein (double arrow) and the inferior vermian vein (double arrowheads).
ANA_21754_sm_SupFig6c.tif362KFig 6 (online only). A 9-year-old boy developed sudden onset of headache with nausea and vomiting. Imaging studies demonstrated a right cerebellar DVA associated with CM in its drainage territory as well as acute hemorrhage of the CM, (A) DSA, anterior-posterior (AP) projection, right vertebral artery injection, venous phase showing the right cerebellar DVA draining into the torcular herophili through an inferior vermian vein (arrow). No evidence of collecting vein stenosis was found. (B) Caput medusae (arrowheads); fast spin-echo (FSE) T2-weighted, axial image showing a CM (single arrow), surrounded by an area of subacute hemorrhage (arrowheads). The collecting vein of the DVA is seen as a flow void (double arrows) and drains into an enlarged inferior vermian vein (double arrowhead). There is perilesional edema in keeping with the subacute hemorrhage. (C) Gadolinium-enhanced gradient-echo (GE) T1, axial image at the same level as (B). The subacute hemorrhage appears hyperintense (arrowheads). There is enhancement of the DVA collecting vein (double arrow) and the inferior vermian vein (double arrowheads).
ANA_21754_sm_SupFig8a.tif250KFig 8 (online only). A 36-year-old woman with history of tuberculum selae meningioma with development of a cavernous malformation in the drainage territory of a DVA. (A) MRI obtained 2 years prior to the present study, axial post-gadolinium T1-weighted image demonstrating a small DVA in the head of the right caudate nucleus (arrowhead); (B, C) current MRI study, axial post-gadolinium T1- and T2-weighted images, respectively, demonstrating the appearance of a cavernous malformation in the head of the right caudate nucleus (arrowhead); (D) retrospectively, the cavernous malformation was visible on the initial MRI study as an inframillimetric T2-weighted hyperintensity in the head of the right caudate nucleus (arrowhead).
ANA_21754_sm_SupFig8b.tif272KFig 8 (online only). A 36-year-old woman with history of tuberculum selae meningioma with development of a cavernous malformation in the drainage territory of a DVA. (A) MRI obtained 2 years prior to the present study, axial post-gadolinium T1-weighted image demonstrating a small DVA in the head of the right caudate nucleus (arrowhead); (B, C) current MRI study, axial post-gadolinium T1- and T2-weighted images, respectively, demonstrating the appearance of a cavernous malformation in the head of the right caudate nucleus (arrowhead); (D) retrospectively, the cavernous malformation was visible on the initial MRI study as an inframillimetric T2-weighted hyperintensity in the head of the right caudate nucleus (arrowhead).
ANA_21754_sm_SupFig8c.tif309KFig 8 (online only). A 36-year-old woman with history of tuberculum selae meningioma with development of a cavernous malformation in the drainage territory of a DVA. (A) MRI obtained 2 years prior to the present study, axial post-gadolinium T1-weighted image demonstrating a small DVA in the head of the right caudate nucleus (arrowhead); (B, C) current MRI study, axial post-gadolinium T1- and T2-weighted images, respectively, demonstrating the appearance of a cavernous malformation in the head of the right caudate nucleus (arrowhead); (D) retrospectively, the cavernous malformation was visible on the initial MRI study as an inframillimetric T2-weighted hyperintensity in the head of the right caudate nucleus (arrowhead).
ANA_21754_sm_SupFig8d.tif276KFig 8 (online only). A 36-year-old woman with history of tuberculum selae meningioma with development of a cavernous malformation in the drainage territory of a DVA. (A) MRI obtained 2 years prior to the present study, axial post-gadolinium T1-weighted image demonstrating a small DVA in the head of the right caudate nucleus (arrowhead); (B, C) current MRI study, axial post-gadolinium T1- and T2-weighted images, respectively, demonstrating the appearance of a cavernous malformation in the head of the right caudate nucleus (arrowhead); (D) retrospectively, the cavernous malformation was visible on the initial MRI study as an inframillimetric T2-weighted hyperintensity in the head of the right caudate nucleus (arrowhead).
ANA_21754_sm_SupFig9a.tif1591KFig 9 (online only). Fortuitous autopsy finding of a left cerebellar DVA in an 80-year-old woman having expired from pulmonary embolism. (A) Hematoxylin-eosin stain, no magnification showing a left cerebellar corpus medullare DVA (arrow). (B) Hematoxylin-eosin stain (magnification ×10) showing dilated medullary veins forming the caput medusae (white arrowheads) converging into a collecting vein (arrow) and separated by normal-appearing parenchyma. The wall of the collecting vein displayed foci of fibrous thickening (black arrowheads), the latter being less pronounced than in Fig 4. (C) Hematoxylin-eosin stain (magnification ×100) showing hemosiderin-laden macrophages (arrowheads) consistent with old hemorrhage in otherwise normally appearing brain tissue. These were sparse around the larger central vein but more abundant around the venous radicles. The absence of scar tissue in the zones of hemosiderin-laden macrophages suggests that extravasation of blood could have occurred by diapedesis rather than from a significant hemorrhage. V = venous lumen. Courtesy of Dr Karim Burkhardt, Department of Clinical Pathology, Geneva University Hospital, Switzerland.
ANA_21754_sm_SupFig9b.tif1436KFig 9 (online only). Fortuitous autopsy finding of a left cerebellar DVA in an 80-year-old woman having expired from pulmonary embolism. (A) Hematoxylin-eosin stain, no magnification showing a left cerebellar corpus medullare DVA (arrow). (B) Hematoxylin-eosin stain (magnification ×10) showing dilated medullary veins forming the caput medusae (white arrowheads) converging into a collecting vein (arrow) and separated by normal-appearing parenchyma. The wall of the collecting vein displayed foci of fibrous thickening (black arrowheads), the latter being less pronounced than in Fig 4. (C) Hematoxylin-eosin stain (magnification ×100) showing hemosiderin-laden macrophages (arrowheads) consistent with old hemorrhage in otherwise normally appearing brain tissue. These were sparse around the larger central vein but more abundant around the venous radicles. The absence of scar tissue in the zones of hemosiderin-laden macrophages suggests that extravasation of blood could have occurred by diapedesis rather than from a significant hemorrhage. V = venous lumen. Courtesy of Dr Karim Burkhardt, Department of Clinical Pathology, Geneva University Hospital, Switzerland.
ANA_21754_sm_SupFig10a.tif291KFig 10 (online only). A 44-year-old woman investigated for vertigo. Fortuitous finding of a small left temporal pole DVA. (A) Axial, noncontrast CT without demonstrable lesion of the left temporal pole. (B) Fast spin-echo (FSE) T2-weighted axial image without demonstrable lesion. (C) Gadolinium-enhanced spin-echo (SE) T1-weighted axial image demonstrating a small left temporal pole DVA (arrow) draining into the deep venous system. (D) Gradient-echo (GE) T2-weighted axial image demonstrates a circumscribed zone of “blooming” effect in the region of the DVA. These findings are suggestive for a CM in formation in the territory of the DVA with hemosiderin deposition from previous microbleeds (not visible on noncontrast CT or other MRI sequences), and could correspond to the radiological appearance of findings illustrated in Fig 10.
ANA_21754_sm_SupFig10b.tif306KFig 10 (online only). A 44-year-old woman investigated for vertigo. Fortuitous finding of a small left temporal pole DVA. (A) Axial, noncontrast CT without demonstrable lesion of the left temporal pole. (B) Fast spin-echo (FSE) T2-weighted axial image without demonstrable lesion. (C) Gadolinium-enhanced spin-echo (SE) T1-weighted axial image demonstrating a small left temporal pole DVA (arrow) draining into the deep venous system. (D) Gradient-echo (GE) T2-weighted axial image demonstrates a circumscribed zone of “blooming” effect in the region of the DVA. These findings are suggestive for a CM in formation in the territory of the DVA with hemosiderin deposition from previous microbleeds (not visible on noncontrast CT or other MRI sequences), and could correspond to the radiological appearance of findings illustrated in Fig 10.
ANA_21754_sm_SupFig10c.tif309KFig 10 (online only). A 44-year-old woman investigated for vertigo. Fortuitous finding of a small left temporal pole DVA. (A) Axial, noncontrast CT without demonstrable lesion of the left temporal pole. (B) Fast spin-echo (FSE) T2-weighted axial image without demonstrable lesion. (C) Gadolinium-enhanced spin-echo (SE) T1-weighted axial image demonstrating a small left temporal pole DVA (arrow) draining into the deep venous system. (D) Gradient-echo (GE) T2-weighted axial image demonstrates a circumscribed zone of “blooming” effect in the region of the DVA. These findings are suggestive for a CM in formation in the territory of the DVA with hemosiderin deposition from previous microbleeds (not visible on noncontrast CT or other MRI sequences), and could correspond to the radiological appearance of findings illustrated in Fig 10.
ANA_21754_sm_SupFig10d.tif295KFig 10 (online only). A 44-year-old woman investigated for vertigo. Fortuitous finding of a small left temporal pole DVA. (A) Axial, noncontrast CT without demonstrable lesion of the left temporal pole. (B) Fast spin-echo (FSE) T2-weighted axial image without demonstrable lesion. (C) Gadolinium-enhanced spin-echo (SE) T1-weighted axial image demonstrating a small left temporal pole DVA (arrow) draining into the deep venous system. (D) Gradient-echo (GE) T2-weighted axial image demonstrates a circumscribed zone of “blooming” effect in the region of the DVA. These findings are suggestive for a CM in formation in the territory of the DVA with hemosiderin deposition from previous microbleeds (not visible on noncontrast CT or other MRI sequences), and could correspond to the radiological appearance of findings illustrated in Fig 10.
ANA_21754_sm_SupFig11a.tif664KFig 11 (online only). Healthy and normally developed 4-year-old boy investigated for bulging subcutaneous mass in the forehead that comes and goes consistent with sinus pericranii. (A) DSA, venous phase of a left carotid artery injection, lateral projection showing two left frontal DVAs. The collecting vein (1) of the largest DVA (DVA#1) drains both into the superior sagittal sinus (arrows) and a frontal sinus pericranii (arrowhead) corresponding to the frontal subcutaneous mass. The collecting vein of the second DVA (2, DVA#2) drains exclusively into the supraorbital and superficial temporal veins (double arrowheads). In this case, the frontal sinus pericranii draining DVA#1 could be occluded surgically without compromising the venous outflow with an excellent result. Care was taken not to occlude the drainage of the second DVA#2 into the supraorbital vein as this represented the only outflow pathway. (B) CT angiography of the head, 3D volume-rendered reconstruction showing the sinus pericranii (arrowhead) draining DVA#1. The double arrowhead shows the supraorbital vein that connected DVA#2 to the superficial temporal veins. (C) CT angiography of the head, 3D volume-rendered reconstruction on bone window showing the bony canal in the frontal bone (arrowhead) through which the DVA connected to the sinus pericranii. Treatment consists in surgically obliterating the outer opening of this bony canal.
ANA_21754_sm_SupFig11b.tif1786KFig 11 (online only). Healthy and normally developed 4-year-old boy investigated for bulging subcutaneous mass in the forehead that comes and goes consistent with sinus pericranii. (A) DSA, venous phase of a left carotid artery injection, lateral projection showing two left frontal DVAs. The collecting vein (1) of the largest DVA (DVA#1) drains both into the superior sagittal sinus (arrows) and a frontal sinus pericranii (arrowhead) corresponding to the frontal subcutaneous mass. The collecting vein of the second DVA (2, DVA#2) drains exclusively into the supraorbital and superficial temporal veins (double arrowheads). In this case, the frontal sinus pericranii draining DVA#1 could be occluded surgically without compromising the venous outflow with an excellent result. Care was taken not to occlude the drainage of the second DVA#2 into the supraorbital vein as this represented the only outflow pathway. (B) CT angiography of the head, 3D volume-rendered reconstruction showing the sinus pericranii (arrowhead) draining DVA#1. The double arrowhead shows the supraorbital vein that connected DVA#2 to the superficial temporal veins. (C) CT angiography of the head, 3D volume-rendered reconstruction on bone window showing the bony canal in the frontal bone (arrowhead) through which the DVA connected to the sinus pericranii. Treatment consists in surgically obliterating the outer opening of this bony canal.
ANA_21754_sm_SupFig11c.tif1814KFig 11 (online only). Healthy and normally developed 4-year-old boy investigated for bulging subcutaneous mass in the forehead that comes and goes consistent with sinus pericranii. (A) DSA, venous phase of a left carotid artery injection, lateral projection showing two left frontal DVAs. The collecting vein (1) of the largest DVA (DVA#1) drains both into the superior sagittal sinus (arrows) and a frontal sinus pericranii (arrowhead) corresponding to the frontal subcutaneous mass. The collecting vein of the second DVA (2, DVA#2) drains exclusively into the supraorbital and superficial temporal veins (double arrowheads). In this case, the frontal sinus pericranii draining DVA#1 could be occluded surgically without compromising the venous outflow with an excellent result. Care was taken not to occlude the drainage of the second DVA#2 into the supraorbital vein as this represented the only outflow pathway. (B) CT angiography of the head, 3D volume-rendered reconstruction showing the sinus pericranii (arrowhead) draining DVA#1. The double arrowhead shows the supraorbital vein that connected DVA#2 to the superficial temporal veins. (C) CT angiography of the head, 3D volume-rendered reconstruction on bone window showing the bony canal in the frontal bone (arrowhead) through which the DVA connected to the sinus pericranii. Treatment consists in surgically obliterating the outer opening of this bony canal.
ANA_21754_sm_SupFig12a.tif424KFig. 12 (online only). A 64-year-old male with a giant venous malformation of the face and right orbit referred for coiling of a right posterior communicating artery aneurysm. (A) MRI, coronal fat-saturated (Fat-Sat) T1 after administration of gadolinium, showing a large venous malformation of the right hemiface and orbit extending into the soft palate. (B) MRI, axial fast spin-echo (FSE) T2-weighted image showing the venous malformation of the right orbit causing exophthalmia of the right eye (compare with normal left orbit). In addition, there are anomalous flow-voids in the right ambiens cistern and mesencephalon (arrowheads) corresponding to collector veins of DVAs; (C) these are better appreciated on a gadolinium-enhanced spin-echo (SE) T1-weighted axial image; d) DSA, right internal carotid artery venous phase, lateral projection showing three DVAs (arrowheads) involving the deep and superficial venous systems. The association between DVAs and venous malformations of the face and orbit are frequent, thus warranting an extensive head and neck workup.
ANA_21754_sm_SupFig12b.tif478KFig. 12 (online only). A 64-year-old male with a giant venous malformation of the face and right orbit referred for coiling of a right posterior communicating artery aneurysm. (A) MRI, coronal fat-saturated (Fat-Sat) T1 after administration of gadolinium, showing a large venous malformation of the right hemiface and orbit extending into the soft palate. (B) MRI, axial fast spin-echo (FSE) T2-weighted image showing the venous malformation of the right orbit causing exophthalmia of the right eye (compare with normal left orbit). In addition, there are anomalous flow-voids in the right ambiens cistern and mesencephalon (arrowheads) corresponding to collector veins of DVAs; (C) these are better appreciated on a gadolinium-enhanced spin-echo (SE) T1-weighted axial image; d) DSA, right internal carotid artery venous phase, lateral projection showing three DVAs (arrowheads) involving the deep and superficial venous systems. The association between DVAs and venous malformations of the face and orbit are frequent, thus warranting an extensive head and neck workup.
ANA_21754_sm_SupFig12c.tif416KFig. 12 (online only). A 64-year-old male with a giant venous malformation of the face and right orbit referred for coiling of a right posterior communicating artery aneurysm. (A) MRI, coronal fat-saturated (Fat-Sat) T1 after administration of gadolinium, showing a large venous malformation of the right hemiface and orbit extending into the soft palate. (B) MRI, axial fast spin-echo (FSE) T2-weighted image showing the venous malformation of the right orbit causing exophthalmia of the right eye (compare with normal left orbit). In addition, there are anomalous flow-voids in the right ambiens cistern and mesencephalon (arrowheads) corresponding to collector veins of DVAs; (C) these are better appreciated on a gadolinium-enhanced spin-echo (SE) T1-weighted axial image; d) DSA, right internal carotid artery venous phase, lateral projection showing three DVAs (arrowheads) involving the deep and superficial venous systems. The association between DVAs and venous malformations of the face and orbit are frequent, thus warranting an extensive head and neck workup.
ANA_21754_sm_SupFig12d.tif479KFig. 12 (online only). A 64-year-old male with a giant venous malformation of the face and right orbit referred for coiling of a right posterior communicating artery aneurysm. (A) MRI, coronal fat-saturated (Fat-Sat) T1 after administration of gadolinium, showing a large venous malformation of the right hemiface and orbit extending into the soft palate. (B) MRI, axial fast spin-echo (FSE) T2-weighted image showing the venous malformation of the right orbit causing exophthalmia of the right eye (compare with normal left orbit). In addition, there are anomalous flow-voids in the right ambiens cistern and mesencephalon (arrowheads) corresponding to collector veins of DVAs; (C) these are better appreciated on a gadolinium-enhanced spin-echo (SE) T1-weighted axial image; d) DSA, right internal carotid artery venous phase, lateral projection showing three DVAs (arrowheads) involving the deep and superficial venous systems. The association between DVAs and venous malformations of the face and orbit are frequent, thus warranting an extensive head and neck workup.
ANA_21754_sm_SupFig13a.tif455KFig 13 (online only). A 46-year-old woman, fortuitous discovery of a Type 1 arteriolized left frontoparietal DVA. DSA, left common carotid artery injection, anterior-posterior (AP) projection. (A) Mid arterial phase showing a blush (arrowheads). Radially-oriented small vessels are suspected. No AVM nidus, direct arteriovenous fistula, or enlarged feeding arteries are demonstrated. (B) Late arterial phase. The caput medusae of the DVA is clearly visible, with a superficial component (a) and a deep component (b). The collecting vein of the DVA (cv) is starting to fill and lateral. (C) Mid venous phase, the collecting vein is now fully opacified; a tight stenosis (arrow) is noted as it crosses the dura to enter the superior sagittal sinus.
ANA_21754_sm_SupFig13b.tif454KFig 13 (online only). A 46-year-old woman, fortuitous discovery of a Type 1 arteriolized left frontoparietal DVA. DSA, left common carotid artery injection, anterior-posterior (AP) projection. (A) Mid arterial phase showing a blush (arrowheads). Radially-oriented small vessels are suspected. No AVM nidus, direct arteriovenous fistula, or enlarged feeding arteries are demonstrated. (B) Late arterial phase. The caput medusae of the DVA is clearly visible, with a superficial component (a) and a deep component (b). The collecting vein of the DVA (cv) is starting to fill and lateral. (C) Mid venous phase, the collecting vein is now fully opacified; a tight stenosis (arrow) is noted as it crosses the dura to enter the superior sagittal sinus.
ANA_21754_sm_SupFig13c.tif464KFig 13 (online only). A 46-year-old woman, fortuitous discovery of a Type 1 arteriolized left frontoparietal DVA. DSA, left common carotid artery injection, anterior-posterior (AP) projection. (A) Mid arterial phase showing a blush (arrowheads). Radially-oriented small vessels are suspected. No AVM nidus, direct arteriovenous fistula, or enlarged feeding arteries are demonstrated. (B) Late arterial phase. The caput medusae of the DVA is clearly visible, with a superficial component (a) and a deep component (b). The collecting vein of the DVA (cv) is starting to fill and lateral. (C) Mid venous phase, the collecting vein is now fully opacified; a tight stenosis (arrow) is noted as it crosses the dura to enter the superior sagittal sinus.

Please note: Wiley Blackwell is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.