Venous malformations are abnormal dilated veins that can occur on the skin, muscles, bones, or organs, including the brain. They can range in size and appearance, and may cause complications such as blood clots or sudden bleeding. Treatment options include laser removal, sclerotherapy, and surgical removal.
A venous malformation is an injury that is the result of dilated veins forming abnormally. These lesions are typically visible on the skin, but can also be present in the muscles, bones or organs. They can occur on the brain, although according to Boston Children’s Hospital, the estimated incidence of this type of venous malformation is only about 0.5%.
Venous malformations are usually dark blue and soft, although they can harden if a clot forms. They can range in size from pinhead-sized spots to large lesions many inches in diameter. A malformation can appear as a single lesion or it can be one of many.
In a venous malformation, the walls of the vein lack the smooth muscle cells that characterize a normal vein. Although the exact cause is unknown, DNA studies in families with multiple venous malformations have shown mutations in the genes responsible for communicating between the cell lining and smooth muscle cells in the vein walls. There is no evidence to support the idea that any food or medication during pregnancy can cause venous malformation.
There are several diseases and conditions involving venous malformations. Glomovenous malformations contain nerve cells and cause the malformations to harden and tighten. These types of malformations can be inherited and often occur in multiple places. Blue rubber bleb nevus syndrome involves numerous gummy lesions that can appear both externally and internally.
Lesions in the stomach or gastrointestinal tract can cause severe abdominal pain and bleeding and usually need to be removed surgically to prevent these types of complications. Maffucci syndrome is characterized by venous malformations and bony growths called enchondromas. These can cause severe deformities that can worsen with age, and lesions and enchondromas can become malignant, so ongoing x-rays and biopsies may be required.
Venous malformations are largely a cosmetic problem, but they can cause other complications as well. They can expand and grow due to age, injury, puberty or pregnancy, and can develop blood clots that can block blood supply to areas surrounding the malformation. Many are also extremely painful and sensitive, making treatment necessary. A venous malformation in the stomach or brain can rupture and cause sudden bleeding, creating a medical emergency.
Very small venous malformations can be treated and removed with a laser, but most require other treatments. The two main treatment options are surgical removal and sclerotherapy. Sclerotherapy involves an injection into the venous malformation to shrink the abnormal vein and reduce the size and appearance of the malformation. These injections may need to be repeated several times, and surgical removal may still be required if sclerotherapy treatment fails.
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