Cirsoid Aneurysms of the Scalp

Abstract

The mode of treatment of a cirsoid aneurysm of the scalp depends mainly on its size; three methods of treatment, with case reports illustrating these, are described.Small Cirsoid Aneurysm A small cirsoid aneurysm which is localized to a small area, and especially if the skin is thin and ulcerated, is treated most expeditiously by complete excision with the overlying scalp, after carefully ligating the vessels supplying it. The defect is then closed by rotating a local flap in order to spread the tension over the whole suture line. Three years previously the swelling had started to increase in size and 'the veins oii the right side of her forehead had become dilated. She had noticed that after exercise the swelling became larger and " throbbing " was felt over it. In May, 1949, a local surgeon ligated both superficial temporal arteries, and the swelling subsided temporarily, but within a month it had regained its previous size.On examination a moderate-sized cirsoid aneurysm was found involving about one-quarter of her scalp. Over the right anterior quadrant of her hairy scalp and the right side of her forehead there were greatly dilated tortuous, hard, and pulsatile veins. A thrill could be felt over them and a " bruit de diable " was present.Operation.-On September 13, 1949, the right external carotid artery was first ligated and a large U flap was then made over the aneurysm. The medial limb of the flap started in the midline just above the base of the nose and extended vertically upwards into the hairline, curving outwards to the right, crossing the parietal and squamous temporal regions, and ending at a point about 1 in. (2.5 cm.) BRrrUH 23Mwic,u JOUMO.L

Sonographic Features of Sinus Pericranii in 4 Pediatric Patients

“…When large, a scalp arteriovenous fistula may also show calvarial erosion or a defect through which intracranial and extracranial vessels communicate. The arteriovenous fistula itself may also have intracranial components when large 16 . However, it shows pulsatile Doppler wave patterns and high‐flow/low‐flow vascular shunting independent of changes in intracranial pressure, whereas sinus pericranii shows changes in the size, shape, and flow direction according to changes in intracranial pressure.…”

Congenital Arteriovenous Malformation of the Scalp Involving the Orbit

“…In one case, reported by Oldfield and Addison in 1962, the scalp AVM was large and connected with an intracranial arteriovenous fistula; the authors considered observation preferable due to the high risks of surgical resection. 33 Final cure after surgical excision is reported in > 90% of operated cases. The observed complications include scalp necrosis (4.5%) and infection (4.5%).…”

Endovascular treatment of scalp cirsoid aneurysms

“…[4][5][6][7][27][28][29][30][31][32] In the past, treatment of arteriovenous malformation of the scalp and face was primarily reliant on surgical excision or ligation of the feeding arteries. [26][27][28][29][30]33] Some…”