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. 2013 Jan;46(1):98-107.
doi: 10.4103/0970-0358.113723.

Surgical management of scalp arterio-venous malformation and scalp venous malformation: An experience of eleven cases

Forhad Hossain Chowdhury  1 , Mohammod Raziul Haque, Khandkar Ali Kawsar, Mainul Haque Sarker, A F M Momtazul Haque
Affiliations

Surgical management of scalp arterio-venous malformation and scalp venous malformation: An experience of eleven cases

Forhad Hossain Chowdhury et al. Indian J Plast Surg. 2013 Jan.

Abstract

Aims: Scalp arterio-venous malformation (AVM) and scalp venous malformation (SVM) are rare conditions that usually need surgical treatment. Here, we have reported our experience of the surgical management of such lesions with a short review of the literature.

Materials and methods: In this prospective study, 11 patients with scalp AVM and SVM, who underwent surgical excision of lesion in our hospital from 2006 to 2012, were included. All suspected high-flow AVM were investigated with the selective internal and external carotid digital subtraction angiogram (DSA) ± computed tomography (CT) scan of brain with CT angiogram or magnetic resonance imaging (MRI) of brain with MR angiogram, and all suspected low-flow vascular malformation (VM) was investigated with MRI of brain + MR angiogram. Eight were high-flow and three were low-flow VM.

Results: All lesions were successfully excised. Scalp cosmetic aspects were acceptable in all cases. There was no major post-operative complication or recurrence till last follow-up.

Conclusions: With preoperative appropriate surgical planning, scalp AVM and SVM can be excised without major complication.

Keywords: Arterio-venous malformation; cavernous angioma; cirsoid aneurysm; scalp AVM; scalp venous malformatiom; sinus pericranii.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
(a) Per-operative picture of lesion. (b) Post-operative picture of patient
Figure 2
Figure 2
(a and b) Pre-operative picture of lesion and patient. (c and d) Post-operative picture patient with good cosmetic outcome
Figure 3
Figure 3
(a and b) CTA of head showing frontal venous malformation (sinus pericranii) with normal intracranial venous sinuses. (c) Per-operative picture of low-flow lesion after exposure. (d) Per-operative picture after complete excision of lesion
Figure 4
Figure 4
(a and b) CTA of extracranial vessel showing left posterior parietal AVM with feeder from superficial temporal and occipital artery
Figure 5
Figure 5
Peroperative picture of temporal cavernoma
Figure 6
Figure 6
(a and b) CT scan of head showing huge diffuse extracranial soft tissue swelling and multiple vascular marking (guttering and erosion by AVM vessels)
Figure 7
Figure 7
(a-i) DSA of ECA and internal carotid artery (ICA) showing bilateral feeding vessels from branches of ECA and ICA through supratrochlear and supraorbital arteries. There was aneurysmic and ecstatic dilatation of right ECA and its branches
Figure 8
Figure 8
(a-c) Immediate pre-operative picture of AVM. (d-f) Immediate post-operative picture of operative site. (g and h) Post-operative picture of 9th post-operative day. (i) Post-operative picture 4 week after operation with good cosmetic outcome
Figure 9
Figure 9
(a and b) Pre-operative picture of patient and lesion. (c) CT scan of head showing extracranial lesion. (d) Per-opeartive picture after complete removal of low-flow vascular malformation
Figure 10
Figure 10
(a) Pre-operative picture of lesion and patient. (b and c) Immediate pre-operative picture of lesion. (d) Post-operative picture of operating site with infection. (e and f) Post-operative picture of patient with ultimate outcome of operating site 2.5 months after operation
Figure 11
Figure 11
(a and b) Post-AVM excisional wound infection and large wound gap. (c and d) Pictures of wound 12 day after second operation (wound closure by rotational flap of scalp). (e and f) Pictures 1 year after operation showing acceptable cosmetic outcome
See this image and copyright information in PMC

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