Presentation
Spontaneous vertigo.
Patient Data
Small curvilinear venous structures converging into a larger collecting vein crossing the left aspect the pons and cerebral peduncle, giving the characteristic caput medusae sign, and draining into the superior petrosal sinus in keeping with a developmental venous anomaly. No associated cavernous malformation is seen.
White matter FLAIR and T2 hyperintensity is noted throughout both cerebral hemispheres and brainstem suggestive of chronic small vessel ischemia.
Case Discussion
MRI features of a developmental venous anomaly of the pons with no associated cavernous malformation which may be seen in ~20% of cases.
Usually, uncomplicated developmental venous anomaly remains asymptomatic and discovered incidentally during CT or MRI exam. Neurological manifestations such as spontaneous vertigo is rarely reported in the literature and probably due to a venous hypertension of the developmental venous anomaly adjacent to vestibular nuclei 1.
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