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Venous angiomas / venous malformations, more appropriately referred to as developmental venous anomalies (DVA) consist of a group of nonhereditary, enlarged medullary venules that converge into an enlarged central trunk. This trunk may then drain superficially or deep. Most often in MCA-supplied regions or near the Vein of Galen, these lesions are often discovered incidentally and may very well be the most common intracranial vascular malformation. Their characteristic appearance on imaging has a plethora of descriptions. Among these, they are most commonly referred to as having a “starbust” or “caput medusae” pattern.
As these lesions are low-flow and low-pressure with intervening brain parenchyma, they typically require no treatment or follow-up. Their association with other vascular malformations (most often cavernomas) will at most prompt a search for such lesions. Otherwise, intervention is only a consideration in the exceedingly rare instances that these lesions cause significant hemorrhage or an unmanageable seizure disorder.