When is an Atypical DVA an AVM? We read with great interest a recent letter in the

American Journal of Neuroradiology by Fushimi et al.1 They report a developmental ve-nous anomaly (DVA) with unusual imaging findings on 3T suscepti-bility-weighted imaging, and they suggest that it may reflect a “rela-tively higher flow in the DVA…”. We wish to suggest that increased flow in a DVA would be considered an atypical feature and may, in fact, reflect that this lesion represents a mixed vascular malformation with some imaging features of both a DVA and an arteriovenous malformation (AVM). Im et al2 reported in the June issue of the Journal of Neurosurgery 15 cases of “Venous Predominant Parenchy-mal Arteriovenous Malformations. ” The editorial in the same issue highlights the difficulty in identifying these unusual AVMs without angiography. It seems to us that this technique of susceptibility-weighted imaging at high field has the potential to differentiate aDVA from a venous predominant parenchymal arteriovenous malforma