engleski

SUBARACHNOIDAL HEMORRHAGE FROM A VENOUS ANGIOMA

Developmental venous anomaly (DVA, venous angioma) is the most often occurring cerebral vascular malformation. The bleeding potential is low, uniformly intraparenchimal, associated with coexisting cavernomas. We report a case of 39-years old male who presented with sudden intense headache during exertion. Brain computerized tomography demonstrated subarachnoidal hemorrhage (SAH) in basilar cisterns and IV ventricle. Magnetic resonance imaging showed an anomalous dilated infratentorial vein, presumably precentral vein, with a high signal intensity on T1 weighted mages. Magnetic resonance angiography showed diminished flow through its distal portion. On subsequent digital subtraction angiography this vein was demonstrated, narrowed and irregular in distal segment. A number of small veins were draining into it, with a characteristic "caput medusae" appearance. There was no evidence of aneurisms, arterio-venous malformations, dural fistulas or cavernous angiomas. To the best of our knowledge, this is the first case of SAH caused by a thrombosed DVA, without parenchymal hemorrhage.

subarachnoidal heamorrhage; venous angioma

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