Cirsoid Aneurysm

  • 文章类型: Case Reports
    环状动脉瘤,以前被确定为动静脉畸形(AVM),代表主要位于头皮内的罕见血管异常。这些异常的典型特征是没有插入的毛细血管,引起广泛的血管化,连接动脉进给器和静脉流出的扩张导管。这份报告详细介绍了一例13岁的男性,患有头皮环状动脉瘤,出现左额叶肿胀的人,伴有头痛和搏动感。通过放射学和组织病理学检查实现了明确的诊断。头皮环状动脉瘤可能是先天性的,也可能是在创伤事件后出现的。临床表现通常在生命的第三个十年出现。常见的临床表现包括明显的,皮下搏动性肿块,抽搐的头痛,耳鸣,和化妆品问题。多样的治疗策略,包括手术切除,血管内栓塞,经皮注射硬化剂,可以根据病变的特定特征使用。
    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.
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  • 文章类型: Journal Article
    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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  • 文章类型: Case Reports
    1例33岁的男性患者被诊断为罕见的枕动脉环状动脉瘤,在全身麻醉下进行手术切除。提出了神经外科和口腔颌面团队的跨学科方法。在这里,我们讨论了治疗枕动脉环状动脉瘤的临床步骤。完全切除和彻底的后续行动无异于导致结果的成功。
    A case of 33 year old man diagnosed with a rare case of Cirsoid aneurysm of occipital artery was treated under general anaesthesia for surgical excision. An interdisciplinary approach of Neurosurgery and Oral and Maxillofacial team was made. Here we have discussed the clinical steps performed in the management of Cirsoid aneurysm of occipital artery. In-toto excision and thorough follow up has uneventfully lead to success in the outcome.
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  • 文章类型: Journal Article
    未经证实:环状动脉瘤是头皮区域的动静脉畸形,通常表现为无痛的搏动性肿块。这些存在于较年轻的年龄组中,并且经常与创伤有关。
    未经评估:已经提出了几种治疗算法,我们报告了我们在唯一手术管理方面的经验。
    UNASSIGNED:对科威特主要国家血管外科服务机构进行的所有头皮血管畸形病例进行回顾性审查。术前数据,包括患者的人口统计学。所有患者均行诊断性血管超声和血管造影。术中和术后数据,记录结果和随访情况.
    未经授权:6例环状动脉瘤患者,四名女性和两名男性,平均年龄为19.7岁(范围,10-33岁)。所有患者均表现为头皮无痛搏动性肿块(前外侧4例,后外侧2例),1例伴有头晕和头痛。发现这些畸形仅由颅外血管喂养,没有颅内通讯。一名患者在切除前进行了术前栓塞,其余的进行了单独的手术切除.术后随访2~5年无并发症及复发。
    UNASSIGNED:囊状动脉瘤可以进行单独的手术切除,在排除颅内沟通后效果极佳。
    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.
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  • 文章类型: Case Reports
    环状动脉瘤(CA)是一种罕见的头皮动静脉瘘。关于儿童CA的发病率和治疗方法的文献很少。我们描述了一个7岁男孩的CA病例,该病例通过血管造影诊断并进行了血管造影栓塞治疗,然后进行了手术切除。
    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.
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  • 文章类型: Journal Article
    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.
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  • 文章类型: Case Reports
    Cirsoid aneurysms are rare arteriovenous malformations without any capillaries interposed and almost always observed in the scalp region. These types of aneurysms are so-called \"cirsoid\" because of their serpiginous appearance. In this report, the authors present the first case of a lethal spontaneous rupture of a cirsoid aneurysm of the splenic artery, which could be diagnosed only by post-mortem histologic examination. The victim was a 70-year-old man who was suddenly found dead in bed while he was hospitalized and waiting for a scheduled cardiac surgery. A forensic autopsy was ordered due to the suspicion that the man\'s death could have been related to medical malpractice. An accurate autopsy and a complete forensic histologic examination could clarify the cause of death, which was identified in the spontaneous rupture of a cirsoid aneurysm of the splenic artery. The case is intended to be used as source data for similar forensic cases, where the cause of a massive hemoperitoneum is difficult to be identified.
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  • 文章类型: Case Reports
    头皮动静脉畸形,也被称为环状动脉瘤,是直接连通的动脉和静脉的复杂集合。随着环形动脉瘤的生长,它可以从多个颅内和颅外血管中吸收血液供应,并累及头皮和面部组织。根据它们的大小和复杂性,可以使用各种策略来治疗它们。
    我们介绍了一个巨大的环形动脉瘤血管内栓塞治疗,切除,使用多个扩张的头皮和面部皮瓣进行重建。一个15岁的男孩出现了一个脉动的左颞叶头皮肿块,该肿块缓慢生长,累及了他的大部分左头皮,并延伸到同侧面部。在他的下一次演讲中,19岁时,他最近出现了偶发性横向视野丧失,畏光,头痛,和眩晕.导管血管造影显示广泛的动静脉畸形,主要由左颞浅表提供,耳后,和枕骨动脉,以及眼动脉,血管造影还显示硬脑膜动静脉瘘。最初,将组织扩张器放置在顶点,枕骨,和左下面部区域。然后病人接受了血管内栓塞术,然后使用多个扩张的头皮和面部皮瓣切除和重建组织缺损。患者恢复良好,无神经功能缺损,症状完全缓解。我们的手术合作使他的发际线和面部对称性得到了整体保留。
    大型环状动脉瘤需要多学科结合栓塞治疗,切除,以及闭合组织缺损的整形外科技术。
    Scalp arteriovenous malformations, also known as cirsoid aneurysms, are complex collections of directly communicating arteries and veins. As a cirsoid aneurysm grows, it can recruit a blood supply from multiple intracranial and extracranial vessels and involve both scalp and facial tissue. Depending on their size and complexity, a variety of strategies can be used to treat them.
    We have presented the case of a giant cirsoid aneurysm treated with endovascular embolization, resection, and reconstruction using multiple expanded scalp and facial flaps. A 15-year-old boy had presented with a pulsatile left temporal scalp mass that had slowly grown to involve most of his left scalp and extend into the ipsilateral face. At his next presentation, at 19 years old, he had recently developed episodic lateral visual field loss, photophobia, headaches, and vertigo. Catheter angiography demonstrated an extensive arteriovenous malformation supplied primarily by the left superficial temporal, posterior auricular, and occipital arteries, as well as by the ophthalmic artery, The angiogram also showed a dural arteriovenous fistula. Initially, tissue expanders were placed in the vertex, occipital, and left lower facial regions. The patient then underwent endovascular embolization, followed by resection and reconstruction of the tissue defect using multiple expanded scalp and facial flaps. The patient recovered well without neurological deficits and had complete resolution of his symptoms. Our surgical collaboration resulted in overall preservation of his hairline and facial symmetry.
    Large cirsoid aneurysms can require multidisciplinary treatment combining embolization, resection, and plastic surgical techniques to close the tissue defects.
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  • 文章类型: Case Reports
    An arteriovenous malformation is a rare vascular anomaly composed of a complex network of interconnected arteries and veins of the scalp. It is usually congenital, but infrequently occurs after trauma. Over the years, several terms have been used to describe these lesions, such as cirsoid/rasemose/arteriovenous aneurysm, plexiform angioma and aneurysma serpentinum, or arteriovenous fistula when a single connection exists. Head and neck malformations occur in 0.1% of the population. Involvement of the superficial temporal artery is rare, occurring in about 0.5% to 2.0% of cases. They are diagnosed by angiography and can be managed by endovascular or open resection. The case of a 23-year-old man who presented with a pulsatile head mass after blunt trauma 5 years prior is presented. This entity was diagnosed as an arteriovenous malformation supplied by the superficial temporal arteries. He subsequently underwent successful open exploration and resection. The information is presented with the patient\'s consent.
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  • 文章类型: Case Reports
    BACKGROUND: Scalp arteriovenous malformations, also known as cirsoid aneurysms, are rare lesions that are congenital, traumatic, or postinfectious in nature. These lesions may be found incidentally or owing to signs and symptoms that they produce, such as an enlarging pulsatile mass, headache, tinnitus, or bleeding. These lesions often constitute high-flow arterial blood from the superficial temporal or occipital arteries with venous outflow into extracranial venous structures.
    METHODS: We describe diagnosis and management of 2 cases of congenital scalp arteriovenous malformations in adolescent patients. One case had more typical vascular supply and outflow, whereas the other case demonstrated more uncommon arterial blood supply from extracranial ophthalmic arteries as well as a component of transosseous venous drainage into the intracranial superior sagittal sinus via emissary veins.
    RESULTS: Treatment of these lesions usually consists of endovascular embolization followed by surgical resection.
    CONCLUSIONS: Both scalp AVMs described were successfully excised after transvenous embolization. Consideration of risks of intracranial venous drainage must be taken into account when evaluating AVM anatomy.
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