Traumatic arteriovenous fistula of the superficial temporal artery

Abstract

Arteriovenous fistulae of the superficial temporal artery are rare, and their principal cause is traumas. Complications include pulsatile mass, headache, hemorrhage and deformities that compromise esthetics. Treatment can be performed using conventional surgery or endovascular methods. The authors describe a case of a 44-year-old male patient who developed a large pulsating mass, extending from the preauricular region to the right parietotemporal and frontal regions after a motorcycle accident. The treatment chosen was complete surgical removal of the pulsatile mass and ligature of the vessels feeding the fistula.Keywords: arteriovenous fistulae; superficial temporal artery; trauma. ResumoAs fístulas arteriovenosas de artéria temporal superficial são raras, sendo o trauma sua etiologia principal. Suas complicações incluem massa pulsátil, cefaleia, hemorragia e deformidade estética. O tratamento pode ser realizado por cirurgia convencional ou endovascular. Os autores relatam o caso de um paciente de 44 anos que evoluiu com massa pulsátil extensa desde região pré-auricular até região parietotemporal e frontal direita após acidente motociclístico. Optou-se por remoção cirúrgica completa da massa pulsátil e ligadura dos vasos nutridores da fístula.Palavras-chave: fístula arteriovenosa; artéria temporal superficial; trauma.

Surgical resection of a complex multiple scalp avf without preoperative embolization: a case report

“…However, Luessenhop found that the risk of recurrence after embolization was high as this method could not deal with all the pericranial vessels (22). Moreover, there are many other complications after embolization such as the pain at the fistula site, tenderness and hyperemia over the skin, necrosis over the lesion, escape of the embolic material to the circulation, and permanent patchy hair loss that may not improve and lead to cosmetic problems (1, 15,17,21). Therefore, subsequent surgical removal of the embolic material is necessary in many cases.…”

“…To avoid torrential hemorrhage, we dissected the huge dilated vessels patiently and carefully as we were cutting the scalp. To ensure a complete resection, both the ligation of proximal feeding arteries (21) and the resection of the draining veins were very important. During surgery, we also found numerous small tortuous draining veins and feeding arteries in the subcutaneous layer of the scalp and these were not detected by preoperative CTA or DSA.…”

“…Computerized tomography angiography (CTA) (Figure 2A dISCuSSIon Scalp arteriovenous fistulas are rare lesions that mainly develop due to head trauma. STA is one of the most common vessels involved because of its long and relatively superficial course in the scalp (17,21). Once the STA is injured, an abnormal communication between arteries and veins would appear.…”

Conquering the Odds: Cirsoid Aneurysm with Holocranial Feeders - Staged Embolization, Excision, and Grafting

“…They generally develop in the trauma background and in patients over 30 years old. Spontaneous AVM of the scalp may present at birth; however, in most patients, it is asymptomatic until adulthood [3,[8][9]. Trauma, pregnancy, or hormonal changes cause deterioration of the symptoms.…”

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“…This may occur following a variety of insults, including: Car accidents, diving accidents, penetrating injuries from assaults with sharp objects, and iatrogenic etiologies, such as temporomandibular joint arthroscopy and punch-graft hair transplantation [1]. The literature related to scalp AVF following hair transplantation is limited primarily to single case reports [2][3][4][5][6][7][8][9][10][11][12][13][14].…”