Nussbaum E S, Heros R C, Madison M T, Awasthi D, Truwit C L
Department of Neurological Surgery, University of Minnesota Hospital and Clinic, Minneapolis, USA.
Neurosurgery. 1998 Aug;43(2):347-51; discussion 351-2. doi: 10.1097/00006123-199808000-00103.
Developmental venous anomalies (DVAs) are common anomalies of intracranial venous drainage that may occur in conjunction with other cerebral vascular malformations. The present case raises important questions regarding the association between anomalous venous drainage patterns and the development of arteriovenous malformations (AVMs).
We present the case of a 24-year-old man with small AVMs fed by the superior cerebellar artery that drained directly into a large DVA of the cerebellum.
The patient was managed conservatively and returned 10 years later with recurrent symptoms. A repeat angiogram demonstrated spontaneous thrombosis of the previously documented AVMs; however, new AVMs at a different site that was also fed by the superior cerebellar artery and drained into the same DVA had appeared. The AVMs were completely embolized, and the DVA was left intact.
Recently, increasing attention has focused on the possible importance of venous outflow disturbance and venous hypertension in the pathogenesis and pathophysiology of AVMs. The potential mechanisms for this association and the implications of the present case are discussed, and the pertinent literature is reviewed.
发育性静脉异常（DVAs）是颅内静脉引流的常见异常，可能与其他脑血管畸形同时出现。本病例引发了关于异常静脉引流模式与动静脉畸形（AVM）发展之间关联的重要问题。
我们报告一例24岁男性病例，其小脑上动脉供血的小型AVM直接引流至小脑的一个大型DVA。
该患者接受保守治疗，10年后因症状复发复诊。重复血管造影显示先前记录的AVM出现自发性血栓形成；然而，在不同部位出现了新的AVM，同样由小脑上动脉供血并引流至同一DVA。这些AVM被完全栓塞，DVA保持完整。
最近，越来越多的关注集中在静脉流出道紊乱和静脉高压在AVM发病机制和病理生理学中的可能重要性。讨论了这种关联的潜在机制以及本病例的意义，并对相关文献进行了综述。
