Surgical management of scalp cirsoid aneurysms: Kuwait experience. (case series)

• Published in: Annals of medicine and surgery Vol. 76; p. 103479
• Main Authors: AlFawaz, Abdullah A., AlShatti, Hamad J., Safar, Ali H.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.04.2022; Elsevier
• Subjects: Case Series; Cirsoid aneurysm; Pre-operative embolization; Scalp arterio-venous malformation; Surgical excision; Surgical excision; Pre-operative embolization; Cirsoid aneurysm; Scalp arterio-venous malformation
• ISSN: 2049-0801; 2049-0801
• DOI: 10.1016/j.amsu.2022.103479

Cirsoid aneurysms are arteriovenous malformations of the scalp region that usually manifest as a painless pulsatile mass. These are present in the younger age group and frequently associated with trauma. Several treatment algorithms have been proposed, and we report our experience with sole surgical management. Retrospective review of all the scalp vascular malformation cases performed in the main national Vascular Surgery Service of Kuwait. Pre-operative data, including patient demographics were obtained. All patients underwent diagnostic vascular Duplex ultrasound and angiography. Intra-operative and post-operative data, including outcomes and follow up were recorded. Six patients with Cirsoid aneurysm, four females and two males, had a mean age of 19.7 years (range, 10–33 years). All the patients presented with a painless pulsating mass in the scalp (4 Anterolateral and 2 posterior), and one case had associated dizziness and headache. These malformations were found to be solely fed by the extra-cranial vessels with no intra-cranial communication. One patient had pre-operative embolization prior to excision, and the rest had sole surgical excision. No postoperatively complications or recurrence were seen at 2–5 year follow up. Cirsoid aneurysms are amenable to sole surgical excision with excellent results after excluding intra-cranial communication. •Cirsoid aneurysms are extra cranial AVMs arising in the scalp•Most patients present with painless mass.•Diagnosis is made with duplex ultrasound and/or CT angiography.•We recommend sole surgical over endovascular therapy or a hybrid approach.