Case of the Week
Section Editors: Matylda Machnowska1 and Anvita Pauranik2
1University of Toronto, Toronto, Ontario, Canada
2BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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October 5, 2017
Developmental Venous Anomaly Associated with Unilateral Dystrophic Calcification of the Basal Ganglia and Thalamus
- Background:
- DVA is the most common cerebral vascular abnormality (3%) and generally follows a benign clinical course.
- In rare cases, chronic venous hypertensive changes in the territory drained by a DVA may lead to dystrophic calcification of the drainage territory.
- This may be related to stenosis of the DVA or may be related to wall thickening and increasing resistance in the absence of frank stenosis.
- Clinical Presentation:
- DVAs are generally incidental findings and are only very rarely symptomatic.
- In this case, the patient’s symptoms were not thought to be related to the imaging appearance. The patient had ipsilateral weakness, resolving spontaneously, which was thought to represent either a TIA or a psychosomatic presentation.
- Key Diagnostic Feature:
- Unilateral calcification of the basal ganglia, without mass effect, associated with a developmental venous anomaly
- Differential Diagnoses:
- Prior unilateral injury such as infection or neoplasm (lymphoma, toxoplasmosis, neurocysticercosis, tuberculosis and other granulomatous diseases, HIV-related infection, chemo or radiotherapy)
- nonketotic hyperglycemic hemichorea-hemiballismus
- Treatment:
- No treatment is required.
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