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Developmental venous anomaly (DVA) is a common congenital vascular abnormality that typically has a benign natural history. The lesion likely occurs after atresia or thrombosis of normal venous structures, leading to compensatory retention of embryologic medullary venules.1,2 These venules form an umbrella- shaped arrangement (caput medusae) and cluster into a large central vein that drains into the deep or superficial venous system.1,2 Spontaneous thrombosis of the central vein of a DVA can rarely occur, and lead to symptomatic nonhemorrhagic venous infarction.2–7
Most reported cases of DVA thrombosis demonstrate no underlying predisposition.2–6 One report of nonhemorrhagic venous infarction attributes thrombosis to hypercoagulability induced by puerperium, oral contraceptive use, and smoking.7 We report a case of DVA thrombosis occurring in a postpartum patient on hormonal contraception.
Case report.
A 16-year-old G1P1 woman presented after three brief simple motor seizures involving the right arm and face occurring over 3 days. She denied persistent symptoms. After the first seizure, she had presented to another hospital and was treated with phenytoin, but did not undergo any neuroimaging studies.
Four years previously, she had three episodes of right face, arm, and leg shaking, lasting 2 minutes, without altered consciousness. A routine EEG revealed occipital slowing, but no epileptiform discharges. Brain MRI revealed multiple small vessels …
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