Cerebral venous angioma (DVA)

David Goldemund M.D.
Updated on 11/03/2024, published on 20/09/2023

  • cerebral venous angioma, also known as Developmental Venous Anomaly (DVA), is a congenital malformation where dilated veins with no abnormal feeding artery (caput medusae sign) converge into a single large abnormal draining vein
  • DVAs rarely bleed  ⇒ if a hemorrhage is present, look for associated cavernous malformation (15-20%), AVM, or a tumor
  • most commonly, DVAs are localized in the parietal and frontal lobes (up to 64%) and cerebellum (up to 30%)
Venous angioma (Developmental venous anomaly)

Clinical presentation

  • commonly asymptomatic (usually an incidental finding on neuroimaging)
  • epileptic seizures
  • headaches
  • venous infarction (in case of rare thrombosis of the draining vein)
  • intracerebral bleeding is rare (0.2-0.4% per year)

Diagnostic evaluation

Venous angioma (DVA)

Venous angioma

Venous angioma on CTA

Differential diagnosis


  • a conservative approach is common for isolated DVA
  • the draining vein often serves as drainage for the surrounding unaffected areas
    • surgical occlusion or spontaneous thrombosis may lead to venous infarction
  • if needed, treat concurrent malformations


  • a benign cerebral vascular malformation in which dilated veins converge into a single large draining vein
  • there is no abnormal feeding artery
  • adjacent brain parenchyma is normal
  • DVAs are considered congenital
  • DVA is primarily diagnosed by MRI or CT angiography
  • SWI is the preferred MRI sequence to detect venous malformations
  • generally asymptomatic (typically incidental finding on neuroimaging)
  • symptoms, if present, are usually secondary to associated lesions (CCM, AVM)
  • thrombosis of the draining vein is an extremely rare complication leading to venous infarction
  • AVM has large feeding arteries, tortuous vessels, and abnormal adjacent brain parenchyma that are not observed in DVAs
  • seizures may occur in the presence of an associated epileptogenic lesion (e.g., cavernoma or dysplasia) or as a result of complications (e.g., venous infarction)
  • typically, no intervention is needed unless associated with other vascular malformations (AVM, cavernous malformation) or symptomatic hemorrhage
  • surgical intervention is rarely indicated and generally not recommended due to the role DVAs play in venous drainage
  • excellent, particularly when isolated; there is no increased risk of bleeding in isolated DVAs
  • typically, routine follow-up is not required unless DVA is associated with other vascular anomalies

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Cerebral venous angioma (DVA)