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Intracranial hemorrhage from developmental venous anomaly

Case contributed by Ho Kyu Lee
Diagnosis certain

Presentation

Lost of consciousness. History of cocaine abuse.

Patient Data

Age: 23
Gender: Male

Extensive cerebellar hematoma with edema causing  4th ventricle compression and caudal descent of cerebellar tonsils. 

Two prominent venous structures with "medusa head appearance" that drain into the straight sinus consistent with developmental venous anomaly. 

Congestive appearance of right transverse and straight sinus was noted. 

Hypoplastic right vertebral artery.

Case Discussion

The developmental venous anomaly is a rare cause of intraparenchymal hematoma. In 15-20% of cases there is association with cavernous or capillary malformations.

In this case the cerebellar hematoma was successfully evacuated. Other findings that could justify the bleeding were ruled out.

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