Superficial head and neck venous malformations - Evaluation of associated cerebral abnormalities in a group of 80 patients

Purpose: Superficial venous malformations are slow-flow vascular malformations that present throughout life. This prospective study was conducted to evaluate the prevalence of coexistent developmental venous anomalies, occult vascular malformations, or other associated cerebral anomalies in patients with superficial venous malformations of the head and neck. Methods: Eighty patients with superficial venous malformations of the head and neck had clinical evaluation, computed tomography (CT) before and after contrast administration, and noncontrast T-1- and T-2-weighted magnetic resonance imaging (MRI). Postcontrast. T-1-weighted imaging was performed in some patients (n = 6), as were magnetic resonance angiography (MRA) using two-dimensional phase contrast techniques (n = 8) and time-of-flight techniques (n = 1), and four-vessel angiography (n = 24). Results: Coexistent developmental venous anomalies (DVAs) were present in 21 (26%) of the 80 patients and were clinically silent in all 21 patients. No other cerebral vascular anomaly was depicted. Intradiploic extension of the superficial venous malformation was observed in 11 patients, and lytic bone lesions were seen in 6, In one man, a meningoencephalocele was associated with DVA. III one woman, an orbital meningocele Tvas present. CT detected a venous malformation in association with cerebellar hypoplasia in one additional case, and in association with an arachnoid cyst in another. Conclusion: Our study of patients with venous malformations of the head and neck revealed a higher prevalence of DVAs of the cerebral nervous system in these patients than is usually observed in the general population. A majority of the concurrent DVAs were situated in the posterior fossa, The concurrent DVAs were more common when the venous malformations were extensive, invading the face unilaterally or bilaterally.