Developmental venous anomalies and cerebral cavernous malformations: Partners in crime

Figure 10  Cerebral cavernous malformation and developmental venous anomaly. A: Non-contrast-enhanced computed tomography obtained in a 67-year-old man presenting to the emergency department due to impaired balance shows a hyperdense lesion in the pons (dashed circle); B and C: On T1-weighted images the lesion displays a heterogeneous but mostly hyperintense signal, suggesting recent hemorrhage (B), while on T2-weighted images (C), a peripheral low-signal hemosiderin rim is noted, and a “popcorn-like” or “mulberry-like” appearance is depicted centrally; D-F: On susceptibility-weighted imaging, the lesion displayed intense blooming. The findings were mostly suggestive of a cerebral cavernous malformation (Zabramski type I or II, due to mixed findings of a “popcorn” appearance and recent bleed) as the underlying diagnosis, which was further verified by the depiction of a large adjacent developmental venous anomaly (arrows).