Giant scalp arteriovenous malformation

Worm, Paulo Valdeci; Ruschel, Leonardo Gilmone; Roxo, Marcelo R.; Camelo, Rafael Costa

doi:10.1590/1806-9282.62.09.828

Cited by 14 publications

(15 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…3 Though still unclear, about 10%-20% of scalp AVMs develop following penetrating or non-penetrating trauma to the scalp. 1 Digital Subtraction Angiography (DSA) is the gold standard in diagnosing and delineating the lesion and excluding an intracranial connection 4 ; however, due to the unavailability of the procedure at our institution, this was not performed. Magnetic Resonance Imaging (MRI) is another option, but this procedure was also not available at our institution.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Medusa’s Wrath: Bleeding Giant Scalp Arteriovenous Malformation in an Adult: A Case Report

Briones

Cruz

Resoco

et al. 2023

Vasc Endovascular Surg

View full text Add to dashboard Cite

Background Scalp arteriovenous malformation (AVM) is a rare congenital disease that may present with massive bleeding. To date, surgical excision remains the definitive management. However, the procedure could lead to intraoperative bleeding due to the tumor’s high blood flow and complex vascularity. Case Report A 49-year old Filipino male presented with a bleeding giant scalp AVM. Computed tomographic scan and duplex studies showed multiple feeding vessels with turbulent flow arising primarily from the right superficial temporal, right posterior auricular, and occipital vessels. Prior to surgery, the patient underwent transfusion due to preoperative hemoglobin of 6 g/dL. Proximal control of the right external carotid artery was performed through a supine position and left in place to reduce the majority of blood flow to the AVM. The patient was turned to a prone position for surgical planning to achieve maximal skin-sparing dissection prior to excision. First, ligation of bilateral superficial temporal and posterior auricular arteries was performed. Next, excision above the periosteum with segmental ligation of feeding vessels around the AVM was carried out. Reconstruction of the defect was done via scalp advancement flap and split-thickness skin grafting. Intraoperative blood loss was 1.6 L. On the sixth postoperative day, the patient was discharged with 100% graft take. Conclusion Management of scalp AV malformation is challenging, and despite measures to decrease intraoperative bleeding, blood loss is still high. While preoperative embolization has been reported to decrease the risk of bleeding, this procedure is not currently available in our setting. Our case highlights the complexity of giant scalp AV malformation management in a limited-resource setting. Even in the absence of endovascular intervention, outright surgical excision of AVM can be performed, albeit with higher levels of blood loss.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Scalp arteriovenous malformation (AVM) is a rare congenital disorder accounting for 8.1% of all vascular malformation. 1 It is an abnormal connection between a feeding artery and draining veins. Patients are usually diagnosed during late childhood to early adulthood.…”

Section: Introductionmentioning

confidence: 99%

Medusa’s Wrath: Bleeding Giant Scalp Arteriovenous Malformation in an Adult: A Case Report

Briones

Cruz

Resoco

et al. 2023

Vasc Endovascular Surg

View full text Add to dashboard Cite

show abstract

“…Recently, endovascular therapy has become the most extensively accepted as a single treatment or combined with open surgery for some complex cases. Endovascular embolization is preferred for small lesions (<4 cm) and fewer feeding/draining vessels ( 19 , 20 ). It has also been used to reduce excessive hemorrhage during surgical procedure.…”

Section: Discussionmentioning

confidence: 99%

Case report: Endovascular treatment of two scalp arteriovenous malformation cases via direct percutaneous catheterization: A case series

Shi

Liu

et al. 2022

Front. Neurol.

View full text Add to dashboard Cite

BackgroundScalp arteriovenous malformations (AVM) are rare vascular malformations reported only in small case series. Scalp AVMs usually present with symptoms, including headache, tinnitus, epilepsy, cerebral ischemia, and necrosis of the scalp, which can cause functional, cosmetic, and psychological problems. There are many difficulties in the treatment of scalp AVM because of its complex characteristics of vascular anatomy, non-uniform structure, and intracranial-extracranial anastomosis.Case descriptionTo illustrate the endovascular treatment of scalp AVM via direct percutaneous puncture while traditional arterial and venous approaches were not available. In this report, access was obtained through a direct puncture of the enlarged frontal vein. Onyx-18 was injected through a microcatheter to occlude draining veins, fistulous connection, and the feeders. An 18-gauge indwelling needle was inserted into draining veins directly. Postembolization angiography demonstrated complete sAVM occlusion immediately and no non-targeted embolization. At a 1-year follow-up, no procedure-related complications and evidence of recurrence were observed.ConclusionThe technique of endovascular embolization via direct percutaneous puncture approach is safe, rapid, and effective for specific sAVM. Treatment options should be made in terms of size, vascular anatomical characteristics of the lesions, patient's preference, cosmetic factors, and available expertise.

show abstract

“…Scalp arteriovenous malformation (AVM) is a rare congenital entity, accounting for only 8.1% of all AVM cases. 1 Generally, scalp AVM presents as a small pulsatile mass; but with time, if untreated, it will progressively enlarge and spread to the entire scalp, giving a grotesque appearance and involves the craniofacial structures and skull bone and even extends intracranially, leading to seizures and hemorrhages. in characterizing the structural complexity, location and the extent of the lesion and assist in appropriate preoperative investigation.…”

Section: Introductionmentioning

confidence: 99%

Successful en bloc resection with acceptable cosmesis of a right recurrent giant scalp-orbital AVM causing severe disfigurement: a case report

Karki

Shrestha

Sedain

et al. 2021

J. Soc. Surg. Nepal

View full text Add to dashboard Cite

Scalp arteriovenous malformation (AVM) accounts for only 8.1% of all AVM cases. These lesions are made up of an abnormal fistulous tangle of tortuous dysmorphic network of vessels “vascular nidus” directly connecting between the feeding arteries and draining veins, without capillary connection, located within the incision subcutaneous layer. With time, these congenital lesions may evolve and enlarge and clinically manifest with variable features. The only effective method of preventing evolution of these malformations is to exclude the lesion completely from the circulation. Involvement of the orbit and face may cause severe facial disfigurement, proptosis, visual obstruction and even facial palsy. These lesions may be complicated by ulceration, infection and profuse bleeding. We present a rare case of 40-year-old female with a recurrent congenital scalp-orbital AVM causing proptosis, visual obstruction on the right eye with severe facial disfigurement. The lesion was successfully excised with acceptable cosmesis and removal of the visual obstruction. A brief literature review, imaging findings and the surgical techniques have been presented.

show abstract

Giant scalp arteriovenous malformation

Cited by 14 publications

References 19 publications

Medusa’s Wrath: Bleeding Giant Scalp Arteriovenous Malformation in an Adult: A Case Report

Medusa’s Wrath: Bleeding Giant Scalp Arteriovenous Malformation in an Adult: A Case Report

Case report: Endovascular treatment of two scalp arteriovenous malformation cases via direct percutaneous catheterization: A case series

Successful en bloc resection with acceptable cosmesis of a right recurrent giant scalp-orbital AVM causing severe disfigurement: a case report

Contact Info

Product

Resources

About