• Kenta Nakase, Yasushi Motoyama, Tokiko Nakai, Yasuhiro Takeshima, Ichiro Nakagawa, Young-Su Park, Chiho Ohbayashi, and Hiroyuki Nakase.
• Department of Neurosurgery, Nara Medical University, Kashihara, Nara, Japan.
• Neurosurgery. 2017 Jun 1; 80 (6): E257-E262.

Background And ImportanceFormation of cavernous malformations (CMs) has been recognized to be associated with developmental venous anomaly (DVA) by many authors. Hemodynamic stress due to venous outflow restriction could be hypothesized as a cause. On the other hand, a rare subgroup of DVA with an arterial component has been reported as likely to hemorrhage or be symptomatic. Cases of arterialized DVAs reported previously have not been associated with the presence of CM.Clinical PresentationWe present herein a case report of arterialized DVA in the brainstem with repeated cerebellar hemorrhage. The 49-year-old patient was treated with surgical evacuation of hematoma. A surgical specimen from the hematoma cavity demonstrated CMs on histological examination.ConclusionTo the best of our knowledge, this represents the first report of CM associated with an arterialized DVA. In addition to venous congestion due to outflow obstruction, bleeding from the arterial component of the DVA might be considered as a cause of CM formation.Copyright © 2017 by the Congress of Neurological Surgeons

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