Intracerebral Hemorrhage due to Venous Thrombosis of Developmental Venous Anomaly during Pregnancy.
BACKGROUND
Nowadays, developmental venous anomaly (DVA) is recognized as the most common cerebral vascular malformation. Most DVAs are diagnosed incidentally on routine brain imaging, but they are occasionally symptomatic. We report the case of a 26-year-old Japanese woman with intracerebral hemorrhage due to venous thrombosis of DVA.


METHODS
We examined her neurologic examinations carefully. We also observed her laboratory data, brain computed tomography (CT), and magnetic resonance imaging (MRI) findings.


RESULTS
She was 8 weeks pregnant and suffered from nausea, vomiturition, and appetite loss because of hyperemesis gravidarum. She presented with a sudden generalized seizure and was referred to our hospital. Brain CT showed a small hemorrhage and a tubular high-density structure compatible with an acutely thrombosed collecting vein in the right frontal lobe. T2*-weighted MRI also revealed a thrombosed collecting vein along with multiple medullary veins, which looked like caput medusa. She was diagnosed with an intracerebral hemorrhage and symptomatic epilepsy secondary to thrombosis of the DVA. After the acute phase of the disease, systemic anticoagulation therapy was administered to the patient to prevent the recurrence of venous thrombosis. We suspected that hyperemesis gravidarum with intravascular dehydration might have increased the risk of thrombosis in this patient.


CONCLUSIONS
Thrombosis of the collecting vein of DVA is extremely rare. This is the first report regarding DVA thrombosis during pregnancy, to our knowledge.
['Seki|Morinobu|M|', 'Shibata|Mamoru|M|', 'Itoh|Yoshiaki|Y|', 'Suzuki|Norihiro|N|']
D000328:Adult D000925:Anticoagulants D020785:Central Nervous System Vascular Malformations D002533:Cerebral Angiography D002543:Cerebral Hemorrhage D002550:Cerebral Veins D003681:Dehydration D005260:Female D006801:Humans D006939:Hyperemesis Gravidarum D020767:Intracranial Thrombosis D008279:Magnetic Resonance Imaging D011247:Pregnancy D011249:Pregnancy Complications, Cardiovascular D012307:Risk Factors D014057:Tomography, X-Ray Computed D020246:Venous Thrombosis
hemorrhage venous thrombosis Developmental venous anomaly pregnancy