2022 Volume 50 Issue 5 Pages 399-403
Scalp arteriovenous malformations (scalp AVMs) are extremely rare. We report a case of excision of a giant scalp AVM. A 45-year-old man developed a subcutaneous hematoma involving the right occiput secondary to a head bruise in childhood. He subsequently observed a soft mass in the same area. His family noticed enlargement of the mass, and he was referred to our department for further evaluation. Angiography revealed a vascular malformation with the occipital and superficial temporal arteries as feeding arteries and the superficial temporal and posterior auricular veins as draining veins. The patient was diagnosed with a scalp AVM, which we excised. Total surgical excision is preferred for scalp AVMs because ligation of feeding arteries alone or inadequate embolization may result in recurrence and AVM enlargement from residual lesions secondary to collateral tract formation. It is important to control blood flow to the lesion, to reduce intraoperative blood loss to the greatest extent possible, and to prevent postoperative complications such as skin infection and necrosis. Preoperative imaging is important for comprehensive evaluation of feeding and draining vessels and to aid with development of an optimal surgical strategy.
