In this issue, Brinjiki et al1 demonstrate a remarkable association between cervicofacial venous malformations (VMs) and cerebral developmental venous anomalies (DVAs), as well as between cervicofacial VMs and dural venous sinus anomalies in a retrospective study involving healthy age- and sex-matched controls. In this study, the venous malformations involving the face and neck drain into the external jugular system and fit into the following criteria: septate lobulated mass hyperintense on T2 and hypointense on T1 MR images without mass effect, the presence of phleboliths and fluid-fluid levels, the absence of vascular flow voids on spin-echo sequences, infiltration of the lesion into tissue planes, the absence of arterial or early venous enhancement, and the presence of diffuse enhancement on delayed MR images. Intracranial venous drainage was evaluated by the presence of a DVA, superficial-versus-deep drainage of a DVA, side and location of a DVA, and the presence of cavernous malformations and dural venous sinus anomalies such as dural ectasia and persistent falcine sinuses (PFS). The authors have also examined the combined VM-DVA cases for their occurrence in the same metamere, either medial prosencephalic, lateral prosencephalic and/or otic (rhombencephalic/mesencephalic) as the case may be. Their findings suggest that VMs result from a segmental in utero insult to cells involved in cerebral/cervicofacial venous development. [Read More]
