Massimi Luca, De Bonis Pasquale, Esposito Giuseppe, Novegno Federica, Pettorini Benedetta, Tamburrini Gianpiero, Caldarelli Massimo, Di Rocco Concezio
Pediatric Neurosurgery, Catholic University Medical School, Rome, Italy.
J Neurosurg Pediatr. 2009 Apr;3(4):307-10. doi: 10.3171/2008.12.PEDS08408.
Scalp masses are not infrequently encountered in daily clinical practice. They are represented by a wide spectrum of different clinical entities and are usually managed by an excision or by simple observation. Although it happens rarely, head lumps may hide an underlying cranioencephalic malformation that has to be preoperatively diagnosed to perform an appropriate treatment. Cerebral arteriovenous malformations (AVMs) are not included among the intracranial malformations connected with a scalp mass. The authors report on the unusual case of a child harboring a complex intracranial AVM that initially presented as a small scalp mass. Actually, this young boy came to the authors' attention just for a small, soft, pulsatile, and reducible mass of the vertex that produced a circumscribed bone erosion. The presence of macrocranium and venous engorgement of the face, however, suggested the presence of an intracranial "mass." The neuroimaging investigations pointed out a temporal AVM causing dilation of the intracranial sinuses and ectasia of the vein of the scalp; one of the veins was appreciable as a lump on the vertex.
头皮肿物在日常临床实践中并不少见。它们表现为各种各样不同的临床病症，通常通过切除或单纯观察来处理。虽然这种情况很少发生，但头部肿块可能隐藏着潜在的颅脑畸形，必须在术前诊断出来以便进行适当的治疗。脑动静脉畸形（AVM）并不在与头皮肿物相关的颅内畸形之列。作者报告了一例不寻常的病例，一名儿童患有复杂的颅内AVM，最初表现为一个小的头皮肿物。实际上，这个小男孩引起作者注意的仅仅是头顶一个小的、柔软的、有搏动且可复性的肿物，该肿物导致了局限性骨质侵蚀。然而，巨颅和面部静脉充血的存在提示颅内有“肿物”。神经影像学检查指出一个颞叶AVM导致颅内窦扩张和头皮静脉扩张；其中一条静脉在头顶处可明显看到呈肿块状。
