Incidentally discovered developmental venous anomaly with an associated white matter changes in a 7-year-old girl: a case report and literature review

TL;DR

A 7-year-old girl had a harmless brain vascular malformation found after a minor head injury, which showed typical imaging features and no symptoms.

Contribution

This case report adds to the understanding of developmental venous anomalies in children with associated white matter changes.

Findings

The DVA was incidentally found and showed classic imaging features without symptoms.

White matter changes were associated with the DVA, likely due to chronic venous hypertension.

The condition remained stable over time with conservative management.

Abstract

Developmental venous anomalies (DVAs) are the most common cerebral vascular malformation, with age-dependent prevalence variation in the pediatric population. We report a case of an incidentally discovered left anterior temporal DVA with associated white matter changes in a previously healthy 7-year-old girl following minor head trauma. Initial computed tomography revealed a temporal lobe hypodensity, prompting magnetic resonance imaging (MRI), which demonstrated a classic DVA with adjacent T2/Fluid-Attenuated Inversion Recovery (FLAIR) hyperintense white matter changes without restricted diffusion, blooming susceptibility, or abnormal enhancement. The patient remained asymptomatic throughout follow-up, with serial magnetic resonance imaging showing stability of both the DVA and parenchymal abnormalities. The association of DVAs with white matter changes is attributed to chronic venous hypertension or altered hemodynamics. While generally benign, DVAs can occasionally cause seizures or rarely hemorrhage in children. This case highlights the characteristic imaging features and typically benign course of DVAs with white matter changes in children, supporting conservative management with clinical and radiological surveillance.

Figures