背景：头皮环状动脉瘤是一种罕见的动静脉瘘，具有创伤性，先天性,医源性,或特发性病因。它的表现范围可以从一个小的肿胀到一个大的脉动质量与耳鸣，头痛,头皮坏死.
方法：一名67岁的女性，自幼以来，她的额头和头部肿胀逐渐增加，没有外伤史。检查显示12×5厘米弯曲的中线肿胀。计算机断层扫描血管造影显示，头皮右额顶区域有大量曲折的血管，没有骨缺损或颅内延伸。头部的对比增强计算机断层扫描未显示颅内病理。诊断为环状动脉瘤，手术是有计划的.制作了一个双冠状切口。解剖并结扎供血动脉。Nidus被小心地分开了，烧灼,并在托托中切除。无意中，解剖乳头时在皮肤上形成了一个扣眼，缝合了。患者在术后第10天出现小面积头皮坏死,被清创和缝合。在6个月的随访中，没有复发的迹象。
结论：手术可以成功治疗带有多个动脉供应的头皮大的环状动脉瘤。谨慎的解剖和止血是必要的，以避免围手术期并发症。
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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