{"id":"1cd2f27c-a113-47f9-bac2-9ca36e15eb39","slug":"idiopathic-cerebellar-hemorrhage-in-a-patient-with-isolated-developmental-venous-anomaly-a-case-report","title":"Idiopathic cerebellar hemorrhage in a patient with isolated developmental venous anomaly: A case report","authors":["Ozan Baskurt","Tufan Hiçdönmez","Kazım Ozenç Mınarecı","Nurperi Gazioglu"],"abstract":"Background: Developmental venous anomalies (DVAs) are benign anatomical variations in venous angioarchitecture. They are considered low-flow malformations and are often incidental and clinically insignificant. Hemorrhagic complications from isolated DVAs are extremely rare, typically occurring due to coexisting cavernous malformation. Case Description: A 33-year-old female presented with severe headaches and vertigo, progressing from balance issues and dizziness. Misdiagnosed initially as Meniere’s disease, her symptoms included left oculomotor nerve palsy, left-sided hemidysmetria, dysdiadochokinesis, and positive Romberg’s sign. Cranial computed tomography revealed an acute hemorrhage in the cerebellar vermis. Contrast-enhanced magnetic resonance imaging and angiography identified an isolated DVA. The absence of substantial mass effect or obstructive hydrocephalus prompted conservative management with steroids and analgesics, leading to full recovery. Conclusion: This case underscores the importance of considering isolated DVA in cerebellar hemorrhage etiology in young adults and conservative treatment is recommended to prevent secondary complications, given the DVA’s role in normal venous drainage. A developmental venous anomaly (DVA) is a benign anatomical variation in the venous angioarchitecture, consisting of clusters of small veins draining into a larger collector vein that either drains into the deep or superficial cerebral venous system.[ 11 ] DVAs are commonly described as incidental findings without clinical significance and are considered low-flow malformations.[ 13 ] A distinctive “caput medusae” sign, seen on enhanced radiologic examination, is characterized by dilated medullary veins conversing on a transcortical collecting vein.[ 3 ] Since hemorrhagic complications are most likely due to a coexisting cavernous malformation (CM) or arteriovenous malformation (AVM), it is very rare for an isolated DVA to hemorrhage.[ 1 , 7 ] In addition, bleeding has mostly been reported as intra-parenchymal in most cases.[ 5 ] Here, we present an extremely rare case of symptomatic isolated DVA-related cerebellar hematoma with fourth ventricle extension, along with its management.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/1cd2f27c-a113-47f9-bac2-9ca36e15eb39/featured/hero-cropped-1781558816084.jpg","publishDate":"2025-03-07T00:00:00.000Z","doi":"10.25259/SNI_1056_2024","categories":["Unique Case Observations","Case Report"],"fullTextUrl":"https://surgicalneurologyint.com/api/articles/1cd2f27c-a113-47f9-bac2-9ca36e15eb39/pdf"}