Radiologic anatomy of draining veins of the cerebral arteriovenous malformations (AVMs)

Abstract Background Draining veins of the arteriovenous malformations (AVMs) can be the cause of hemorrhages, and the subject of a specific treatment. However, there are very scarce reports about their radiologic anatomy. Methods Fifty-seven patients with cerebral AVMs were enrolled, almost with equal number of males and females. All of them underwent a neurologic examination, and then digital subtraction angiography, and computerized tomographic angiography. The obtained data were statistically analyzed. Results The 57 patients had AVMs most often located in the frontal region (17.6%), and in the temporal and parietotemporal area (15.8% each). Supratentorial location existed in 88.4%, and infratentorial in 12.6%. Their draining veins ranged 1–17 in number (mean, 2.19). Singular veins were present in 22.8%, and double in 59.7%. Most of draining veins entered the superior sagittal sinus and other superficial vessels (63.2%), some terminated into deep veins or sinuses (12.3%), whilst both sites were present in 24.5%. Dilated draining veins existed in 88.9%, and venous aneurysms in 8.8%. An AVM hemorrhage was the initial sign in 49.2%. As for the AVMs treatment, endovascular embolization was performed (15.8%), surgical intervention (12.3%), and gamma knife irradiation (21.1%), whilst the remaining patients were treated conservatively, with a total mortality rate of 7.2%. Conclusion Draining veins, which averaged 2.19 in number, terminated in various venous vessels. Most of them were dilated and tortuous, with rare aneurysms. A hemorrhage appeared in a half of the patients. Most of AVMs were treated by endovascular, neurosurgical, or radio-surgical interventions.