Scalp Arteriovenous Malformation, "Cirsoid Aneurysm" in Adolescence: Report of 2 Cases and Review of the Literature

Li, D.; Heiferman, D. M.; Rothstein, B. D.; Syed, H. R.; Shaibani, A.; Tomita, T.

World Neurosurg. 2018 Jun 5

Abstract

Scalp arteriovenous malformations (AVM), also known as cirsoid aneurysms, are rare lesions that are congenital, traumatic or post-infectious in nature. These lesions may be found incidentally or due to the signs and symptoms that they produce, such as an enlarging pulsatile mass, headache, tinnitus or bleeding. Treatment of these lesions usually consists of endovascular embolization followed by surgical resection. These lesions often constitute high flow arterial blood from the superficial temporal or occipital arteries with venous outflow into extracranial venous structures. We present the diagnosis and management of two cases of congenital scalp AVMs diagnosed during adolescence, one with more typical vascular supply and outflow, while the other case demonstrates more uncommon arterial blood supply from extracranial ophthalmic arteries, as well as a component of transosseous venous drainage into the intracranial superior sagittal sinus (SSS) via emissary veins. Both scalp AVMs were successfully excised after transvenous embolization.

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