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Caput Medusa in the Brain

Andreas K. Demetriades, MBBChir, MPhil, MRCS(Edin), MRCS(Eng); John S. Norris, FRCS(SN)

Arch Neurol. 2009;66(11):1421.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

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.

Venous drainage of the right hemisphere was via a large vein of Labbé, collecting the superficial sylvian territory and anastomosing with an anterior subfrontal vein. There was no venous outflow obstruction, arteriovenous malformation, arteriovenous fistula, or aneurysm. An electroencephalogram appeared normal. The patient remains well 2 years later, . . . [Full Text of this Article]

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