Surgical management of scalp cirsoid aneurysms: Kuwait experience. (case series).

BACKGROUND

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.

OBJECTIVES

Several treatment algorithms have been proposed, and we report our experience with sole surgical management.

METHODS

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.

RESULTS

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.

CONCLUSIONS

Cirsoid aneurysms are amenable to sole surgical excision with excellent results after excluding intra-cranial communication.