Cirsoid aneurysms, formerly identified as arteriovenous malformations (AVMs), represent infrequent vascular anomalies primarily localized within the scalp. These anomalies are typified by the absence of interposing capillaries, giving rise to extensively vascularized, expanded conduits connecting arterial feeders and venous outflows. This report details a case of a 13-year-old male afflicted with a cirsoid aneurysm in the scalp, who presented with swelling on the left frontal region, accompanied by headache and pulsatile sensations. Definitive diagnosis was achieved through radiological and histopathological examinations. Scalp cirsoid aneurysms may either be congenital in nature or arise following traumatic incidents, with clinical manifestations typically surfacing in the third decade of life. Common clinical presentations encompass a palpable, pulsatile subcutaneous mass, throbbing headaches, tinnitus, and cosmetic concerns. Diverse therapeutic strategies, including surgical excision, endovascular embolization, and percutaneous injection of sclerosing agents, can be employed contingent upon the particular characteristics of the lesion.

To evaluate the efficacy of the combined approach of preoperative endovascular embolization (EE) and surgical excision (SE) for scalp arteriovenous malformation (AVM) and present an illustrative case report.
A systematic review was conducted using online databases (PubMed/Medline, Cochrane, and Embase) on February 15, 2023. The inclusion criteria were any type of study of patients with scalp AVMs who were diagnosed and confirmed through angiography and treated with combined preoperative EE and SE. All the articles that met the inclusion criteria were included in this study.
A total of 49 articles (91 patients) were included. The patients\' age ranged from 10 days to 70 years at the time of presentation. The most common symptoms were a pulsatile mass in 51 patients (56.04%), progressively growing mass in 31 patients (34.06%), and bruits and/or thrills in 22 patients (24.17%). Complications of preoperative EE and SE were observed in only 5 patients; 3 patients (3.29%) had harvested skin graft marginal necrosis, 1 patient (1.09%) had skin necrosis, and 1 patient (1.09%) had a wound infection. Only 2 patients (2.19%) reported a recurrent or residual mass during a median follow-up period of 12 months.
The management of scalp AVMs can be challenging; therefore, focused, and accurate identification of the complexity of the vascular anatomy is required. The combined method of preoperative EE and SE showed satisfactory outcomes with low rates of complications and recurrence; thus, we recommend this approach for the management of scalp AVMs.

BACKGROUND: 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.
METHODS: 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.
CONCLUSIONS: 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.

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Cirsoid aneurysms (CAs) of the scalp are rare arteriovenous malformations presenting as nodular lesions of the scalp. Depending on the size and intracranial extension, they can vary from asymptomatic to potentially lethal from secondary hemorrhage. Being vascular clinically misdiagnosed cases may lead to a devastating outcome from any kind of diagnostic surgical intervention. Here, we report a case of a 45-year-old woman who presented with multiple papulonodular lesions on the scalp, diagnosed as CA.

UNASSIGNED: 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.
UNASSIGNED: Several treatment algorithms have been proposed, and we report our experience with sole surgical management.
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: Cirsoid aneurysms are amenable to sole surgical excision with excellent results after excluding intra-cranial communication.

Cirsoid aneurysm (CA) is a rare arteriovenous fistula of the scalp. There exists scant literature on the incidence and approach to CA in children. We describe a case of CA in a 7-year-old boy which was diagnosed by angiography and managed with angiographic embolization followed by surgical excision.

BACKGROUND: Cirsoid aneurysms, also known as arteriovenous malformations (AVMs), of the scalp are relatively rare lesions. They may be found incidentally or with symptoms such as an enlarging pulsatile mass, headache, or bleeding.
METHODS: This retrospective case series comprised 10 cases of scalp AVMs that were treated with surgical excision from January 2010 to January 2020. Diagnosis was made with simple palpation and computed tomography angiography. Scalp AVMs were categorized according to the Schobinger classification.
RESULTS: There were 10 patients, 8 males and 2 females, with a mean age of 22.6 years (range, 10-40 years). All patients underwent ligation of the feeding artery with total excision of the AVM. There were no postoperative complications or recurrences during a mean follow-up of 21.6 months.
CONCLUSIONS: Preoperative embolization reduces vascularity and helps in easy identification as well as complete excision of cirsoid aneurysms during surgery. However, surgical excision alone of cirsoid aneurysms also results in excellent outcomes.

Scalp cirsoid aneurysm is an arteriovenous fistula of the scalp that is unconnected by intracranial or cerebral vessels. Variceal dilatation of draining veins can produce cosmetic concerns, masses, local pain, palpable thrills, and audible bruits, headache, tinnitus, and hemorrhage. Its etiopathogenesis is not well understood. Treatment includes surgery (fistula repair by simple surgical ligation until gross total resection), embolization (whether percutaneous or endovascular), or a combination of the two. An updated systematic review of the last 10 years publications was performed. Also, we report an illustrative case of a young boy with posttraumatic cirsoid aneurysm and good documentation on head vascular examinations, treated by multiple routes (percutaneous embolization with coils and endovascular embolization with cyanoacrylate) with a decrease of the pulsatile mass. A plastic surgery team performed gross total resection, and the final esthetic result was extremely satisfactory.

BACKGROUND: Scalp AVM (SAVM) is a rare condition. Although surgical excision is considered as definitive treatment for these lesions, troublesome intraoperative bleeding may pose a challenge. Embolization as an alternative modality is gaining popularity. Proximal feeding artery temporary clipping has been utilized by the authors in this series to address troublesome intraoperative bleeding.
UNASSIGNED: The authors present their experience in the surgical management of 3 cases with SAVMs using proximal feeding artery temporary occlusion followed by total surgical excision. The clinical presentations and radiological features of these cases are discussed in the article. Intraoperative blood loss was less than 150ml in all patients. Postoperative period was uneventful with no morbidity or mortality.
CONCLUSIONS: Intraoperative bleeding during surgical excision of scalp AVMs can be troublesome and challenging. To combat this, the authors advocate proximal feeding artery temporary clipping prior to surgical excision of the lesion. The external carotid artery was temporarily clipped in one case and superficial temporal artery in two patients.
CONCLUSIONS: Although most SAVMs can be operated by traditional method of excision, use of temporary clipping of feeding arteries (like Superficial temporal artery[STA], External carotid artery[ECA]) enables total excision of giant SAVMs with minimal blood loss for a definitive cure. This novel technique obviates the need for preoperative embolization.