Large deep venous anomaly presenting as a left frontal lesion

Abstract

Venous angiomas’ also known as deep vein anomalies (DVA), are one of the well-described brain vascular malformations. Frequently they are diagnosed as an incidental finding on neuroimaging (CT or MRI). A DVA may present as a single enhancing venous channel or as a large vascular abnormality illustrated on cerebral angiogram. Such a large DVA may mimic other intracranial lesions that mandate surgical intervention. We describe the radiological findings on CT, MRI, MRA and cerebral angiography of a 26-year-old male who presented with a few months’ history of recurrent attacks of light-headiness, dizziness and slurring of speech that usually lasted for 2 minutes and resolved spontaneously. Cerebral angiography illustrated enlarged medullary veins draining into a central venous trunk then into the superior sagittal sinus resembling a caput medusa sign. Large DVAs may present radiologically as a brain lesion. Early recognition of these anomalies would avoid unnecessary or harmful intervention of this, otherwise, benign pathology.