2000 Volume 9 Issue 2 Pages 86-91
Because the congenital arteriovenous malformation(AVM)of the scalp is rare, the treatment of this lesion has still been controversial. Although a few examples of interventional embolization with various embolic materials for this lesion have been reported, the surgical excision has been the most popular for curative treatment. During surgery, an aggressive excision of the malformation from the adjacent scalp causes the wall of wound to heal, but it can also result in skin necrosis and bleeding into the scalp. The devascularization of the wound can cause these complications postoperatively. We present a case of congenital AVM of the scalp treated with rotation scalp flap without these complications. The patient was a 14-year-old boy with a pulsatile scalp mass at the right parietal region. He had no history of trauma. Radiological examination showed an AVM of the scalp fed by the right superficial temporal artery, the posterior auricular artery and the occipital artery. Surgical resection of the malformation and reconstructive closure of the scalp defect, using rotation flap, were performed. The postoperative course was uneventful and the patient was discharged without skin necrosis or cicatricial alopecia. The goal of the treatment for this lesion is the total excision of malformations without any deforming scar. If the AVM of the scalp is not very large, we recommend the en bloc resection of the scalp with the AVM and closure of the scalp defect by using rotation flap, as the best method of treatment.
