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AJNR - American Journal of Neuroradiology

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Bilateral Cerebral Venous Angioma Associated with Varices: A Case Report and Review of the Literature

Surjith Vattoth, Sukalyan Purkayastha, E.R. Jayadevan and Arun Kumar Gupta

From the Department of Radiology, Sree Chitra Tirunal Institute of Medical Sciences and Technology, Trivandrum, Kerala, India

View larger version (68K): [in a new window]   FIG 1. A, Noncontrast axial CT scan shows an isoattenuated extraaxial lesion anterior to the right temporal pole. B, Contrast-enhanced axial CT scan shows intense enhancement of the lesion. C, Contrast-enhanced axial CT scan shows multiple subependymal veins joining to form collector veins unifying into a tortuous channel in the region of the right sylvian fissure and continuing to the region of the anterior temporal enhancing extraaxial lesion. Abnormal enhancing vessels are also seen in the left frontal region.

View larger version (77K): [in a new window]   FIG 2. A, -B, Right and left internal carotid artery angiograms show a normal arterial phase.

View larger version (84K): [in a new window]   FIG 3. A, -B, Anteroposterior view of early and late venous phases of the right internal carotid artery angiograms shows the presence of 2 varices and the venous angioma.

View larger version (145K): [in a new window]   FIG 4. Lateral view of the venous phase of the right internal carotid artery angiogram shows a classic "Medusa head" appearance with a draining vein varix in the region of the right superficial middle cerebral vein.

View larger version (141K): [in a new window]   FIG 5. Lateral view of the venous phase of the left internal carotid artery angiogram shows a classic "Medusa head" appearance draining into the superior sagittal sinus.