IJNS 2016; 05(02): 129-132
DOI: 10.1055/s-0036-1581974
Images in Neurosurgery
Thieme Medical and Scientific Publishers Private Ltd.

Cirsoid Aneurysm of the Scalp: A Case Report

Mayur Vinod Barhate
1  Department of General Surgery, B.J. Medical College and Sassoon General Hospital, Pune, India
,
Sanjay Shantilal Vhora
2  Department of Neurosurgery, B.J. Medical College and Sassoon General Hospital, Pune, India
,
Rohit Kumar Pandey
1  Department of General Surgery, B.J. Medical College and Sassoon General Hospital, Pune, India
› Author Affiliations
Further Information

Publication History

29 December 2015

14 January 2016

Publication Date:
08 June 2016 (online)

  

Abstract

Cirsoid aneurysms (arteriovenous malformations [AVMs]) of the scalp are rarely encountered in neurosurgical practice. Patients with AVM of the scalp present clinically at times with headache and a small innocuous-looking subcutaneous scalp lump or a large, pulsatile mass with or without bruit, which has a propensity to massive hemorrhage. Complex vascular anatomy and interconnections, high shunt flow, and possible cosmetic complications tend to make their management difficult. We report a rare case of young man who presented with progressively enlarging swelling over left fronto-temporo-parietal and occipital region of the scalp since 8 years. Digital subtraction angiography of internal and external carotid vessels revealed high-flow, complex left parietal scalp AVM supplied by multiple tortuous feeders from left superficial temporal artery (STA), left middle meningeal artery, left occipital artery with collateral supply from right occipital artery, and right STA. Drainage into external jugular vein through multiple tortuous frontal, temporal, and occipital scalp veins with venous varix. Being high-flow shunt and because of suspected cosmetic complications, surgical excision was considered.