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Images in Neurology
November 2009

Deep Venous Anomaly: Caput Medusa in the Brain

Arch Neurol. 2009;66(11):1421. doi:10.1001/archneurol.2009.238

A 24-year-old man presented with a left facial partial seizure. He had no neurological deficit. Brain magnetic resonance imaging showed a possible vascular malformation in the deep right frontal semiovale white matter, a serpiginous structure extending toward the medial right convexity, demonstrating a flow void on T2 images. There was no parenchymal or extraaxial hemorrhage.

Digital subtraction angiography revealed a large developmental venous anomaly (DVA) in the paramedian right midfrontal lobe, draining the deep white matter via 2 transcortical veins toward the anterior superior sagittal sinus, that resembled a caput medusae.

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