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孤立性发育性静脉异常患者的特发性小脑出血:一例报告。

Idiopathic cerebellar hemorrhage in a patient with isolated developmental venous anomaly: A case report.

作者信息

Baskurt Ozan, Hiçdönmez Tufan, Mınarecı Kazım Ozenç, Gazioglu Nurperi

机构信息

Department of Neurosurgery, Istanbul Arel University Faculty of Medicine, Memorial Bahcelievler Hospital, Istanbul, Turkey.

Department of Neurosurgery, Istinye University Faculty of Medicine, Liv Hospital, Istanbul, Turkey.

出版信息

Surg Neurol Int. 2025 Mar 7;16:82. doi: 10.25259/SNI_1056_2024. eCollection 2025.

Abstract

BACKGROUND

Developmental venous anomalies (DVAs) are benign anatomical variations in venous angioarchitecture. They are considered low-flow malformations and are often incidental and clinically insignificant. Hemorrhagic complications from isolated DVAs are extremely rare, typically occurring due to coexisting cavernous malformation.

CASE DESCRIPTION

A 33-year-old female presented with severe headaches and vertigo, progressing from balance issues and dizziness. Misdiagnosed initially as Meniere's disease, her symptoms included left oculomotor nerve palsy, left-sided hemidysmetria, dysdiadochokinesis, and positive Romberg's sign. Cranial computed tomography revealed an acute hemorrhage in the cerebellar vermis. Contrast-enhanced magnetic resonance imaging and angiography identified an isolated DVA. The absence of substantial mass effect or obstructive hydrocephalus prompted conservative management with steroids and analgesics, leading to full recovery.

CONCLUSION

This case underscores the importance of considering isolated DVA in cerebellar hemorrhage etiology in young adults and conservative treatment is recommended to prevent secondary complications, given the DVA's role in normal venous drainage.

摘要

背景

发育性静脉异常(DVAs)是静脉血管结构中的良性解剖变异。它们被认为是低流量畸形,通常是偶然发现且临床意义不大。孤立性DVAs引起的出血并发症极为罕见,通常是由于并存海绵状畸形所致。

病例描述

一名33岁女性出现严重头痛和眩晕,最初由平衡问题和头晕发展而来。最初被误诊为梅尼埃病,其症状包括左侧动眼神经麻痹、左侧偏身运动失调、轮替运动障碍和闭目难立征阳性。头颅计算机断层扫描显示小脑蚓部急性出血。增强磁共振成像和血管造影发现一个孤立的DVA。由于没有明显的占位效应或梗阻性脑积水,采取了使用类固醇和镇痛药的保守治疗,患者完全康复。

结论

本病例强调了在年轻成人小脑出血病因中考虑孤立性DVA的重要性,鉴于DVA在正常静脉引流中的作用,建议采取保守治疗以预防继发性并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f93c/11980714/da36878390c2/SNI-16-82-g001.jpg

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