Management of Ruptured Scalp Arteriovenous Malformation: A Rare Case and Literature Review

Isaac Okyere,Perditer Okyere,Samuel Gyasi Brenu,Sanjeev Singh,Paa Kwesi S Fiifi-Yankson,Boutros F Farhat

doi:10.4236/wjcs.2020.1012029

Abstract

Arteriovenous malformation (AVM) are vascular anomalies that arise due to abnormal connection with shunting of blood from arteries to veins without an intervening capillary network. They are mostly found intracranially but extracranially, the scalp AVM cases are also well reported. However, arteriovenous malformation (AVM) of the scalp is a rare lesion whose natural history is not clearly understood. The clinical manifestation of AVM includes asymptomatic state, local discomfort, headaches and occasional scalp necrosis leading to massive haemorrhage. CT or MR angiography remains the cornerstone for investigation. The options of treatment include complete surgical excision, embolization or a combination of the two modalities. We present the successful management of a young man who presented with a torrential bleeding from a ruptured scalp arteriovenous malformation and had to undergo emergency complete excision followed with a rotational flap for the scalp reconstruction.

Highlights

Arteriovenous malformation (AVM) of the scalp is a rare vascular lesion
Arteriovenous malformation (AVM) are vascular anomalies that arise due to abnormal connection with shunting of blood from arteries to veins without an intervening capillary network
We present the successful management of a young man who presented with a torrential bleeding from a ruptured scalp arteriovenous malformation and had to undergo emergency complete excision followed with a rotational flap for the scalp reconstruction

Summary

Introduction

Arteriovenous malformation (AVM) of the scalp is a rare vascular lesion. They arise due to abnormal connection with shunting of blood from arteries to veins. It is mostly found intracranially but extracranial cases are well reported [1]. AVM of the scalp is a rare occurrence when compared to other craniofacial or subcutaneous vascular abnormalities [3]. The high-flow vascular lesion arises from an abnormal arteriovenous connection within the subcutaneous layer of the scalp causing significant aesthetic and psychological complications [4] [5] [6]. The veins subsequently undergo progressive dilatation and aneurysmal changes that can lead to necrosis of the skin and massive bleeding occasionally with high mortality

Case Report

Discussion

Findings

Okyere et al DOI

Conclusion