We report a symptomatic developmental venous anomaly (DVA) not causing parenchymal abnormality to provide a pathophysiologic clue in patients with recurrent transient neurologic deficit. A 32-year-old male presented with recurrent transient motor aphasia and headache in the left fronto-temporal region for three years. The symptoms usually lasted for one hour. Brain computed tomography (CT) angiography and magnetic resonance imaging using gradient recalled echo showed a prominent penetrating vein at the left frontal periventricular region. Brain CT perfusion imaging performed during the symptoms revealed increased perfusion in the corresponding area with relatively decreased perfusion in the left fronto-temporal cortices. Digital subtraction angiography revealed collecting venous blood from the left septal and thalamostriate veins draining into the left cavernous sinus without early arteriovenous shunting. In this patient, an inciting incident might have led to imbalance of the venous flow surrounding the DVA, causing venous hypertension and the intracerebral steal phenomenon in the surrounding area. The relatively hypoperfused cortical area adjacent to the DVA could be considered the cause of the transient motor aphasia, while venous hypertension could be the cause of the headache.

我们报告了一种没有引起实质异常的症状性发育性静脉异常 (DVA)，为复发性短暂性神经功能缺损患者提供了病理生理学线索。一名 32 岁男性因左侧额颞区反复短暂性运动失语和头痛 3 年就诊。症状通常持续一小时。使用梯度回声的脑计算机断层扫描 (CT) 血管造影和磁共振成像显示左额脑室周围区域有一条突出的穿透静脉。在症状期间进行的脑 CT 灌注成像显示相应区域的灌注增加，而左侧额颞叶皮质的灌注相对减少。数字减影血管造影显示从左侧间隔和丘纹静脉收集静脉血，流入左侧海绵窦，没有早期动静脉分流。在该患者中，一个煽动性事件可能导致 DVA 周围的静脉血流不平衡，从而导致静脉高压和周围区域的脑内偷窃现象。与 DVA 相邻的相对低灌注的皮质区域可被认为是暂时性运动性失语的原因，而静脉高压可能是头痛的原因。