• Philipp Dammann, Karsten H Wrede, Stefan Maderwald, Nicolai El Hindy, Oliver Mueller, Bixia Chen, Yuan Zhu, Bernd-Otto Hütter, Mark E Ladd, Marc Schlamann, I Erol Sandalcioglu, and Ulrich Sure.
• Department of Neurosurgery, University Hospital Essen, Hufelandstrasse 55, Essen 45122, Germany. philipp.dammann@uk-essen.de
• J. Neurol. Neurosurg. Psychiatr.. 2013 Feb 1;84(2):194-200.

Background And PurposeTo test the hypothesis that sporadic cerebral cavernous malformations (CCMs) are systematically associated with venous malformations (VMs) using susceptibility weighted imaging (SWI) at 7 Tesla (T) field MRI.MethodsA prospective unselected series of 20 patients with symptomatic or asymptomatic sporadic CCM diagnosed using 1.5 T MRI was additionally scanned using high resolution (250 µm(2) in-plane) SWI at 7 T MRI. Imaging data were analysed to examine the presence and formation of CCM associated venous vessel structures. Interobserver agreement was assessed using kappa statistics.ResultsIn the 20 patients harbouring 23 CCMs, a solitary or multiple venous drainage was found in all lesions. A 'typical' VM was found in seven lesions. In the other cases, associated abnormal venous structures were also depicted although they appeared structurally different. Excellent interobserver agreement was achieved (95% confidence interval 0.92 to 0.99).ConclusionsOur data support previous assumptions that sporadic CCMs are systematically associated with local venous abnormalities involving larger outflow vessels. However, the typical appearance of a VM was not confirmed in all cases. The role of the venous environment in the pathomechanism of CCMs remains unclear.

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