%0 Journal Article
%T A large cirsoid aneurysm of the scalp with multiple arterial supply: illustrative case.
%A Pahari S
%A Bhandari PB
%A Bhattarai B
%A Baniya P
%A Yadav S
%A Subedi P
%A Mandal S
%J J Neurosurg Case Lessons
%V 7
%N 4
%D 2024 Jan 22
%M 38252931
暂无%R 10.3171/CASE23551
%X <B>BACKGROUND: </B>Cirsoid aneurysm of the scalp is a rare arteriovenous fistula having a traumatic, congenital, iatrogenic, or idiopathic etiology. Its presentation can range from a small swelling to a large pulsatile mass with tinnitus, headache, and scalp necrosis.<BR><B>METHODS: </B>A 67-year-old female presented with a gradually increasing swelling on her forehead and head since childhood and no history of trauma. Examination revealed 12 × 5 cm tortuous midline swelling. Computed tomography angiography revealed a mass of tortuous vessels in the right frontoparietal region of the scalp with no bony defect or intracranial extension. Contrast-enhanced computed tomography of the head showed no intracranial pathology. The diagnosis of cirsoid aneurysm was made, and surgery was planned. A bicoronal incision was made. The feeding arteries were dissected and ligated. The nidus was carefully separated, cauterized, and excised in toto. Inadvertently, a buttonhole in the skin was created while dissecting the nidus, which was sutured. The patient developed a small area of scalp necrosis on the 10th postoperative day, which was debrided and sutured. At the 6-month follow-up, no signs of recurrence were present.<BR><B>CONCLUSIONS: </B>A large cirsoid aneurysm of the scalp with multiple arterial supplies can be treated successfully with surgery. Meticulous dissection and hemostasis are warranted to avoid perioperative complications.