Xie Ming-Chen, Wang Fu-Xu, Xu Jian
Department of Neurosurgery, The Affiliated Hospital of Qingdao University, Qingdao 266000, Shandong Province, China.
World J Clin Cases. 2024 Jun 6;12(16):2869-2875. doi: 10.12998/wjcc.v12.i16.2869.
Vascular malformations (VMs) arise as a result of errors in the process of angiogenesis and are usually present at birth, but may not become apparent until after birth. However, giant VMs of the head and face are uncommon, with few reported cases, and the prognosis for their surgical intervention is unclear.
A 12-year-old girl was admitted to the hospital with findings of an enlarged right temporal scalp. After admission, computed tomography (CT) angiography of cerebral ateries showed a right occlusal gap and a right temporal artery venous malformation. Furthermore, cerebral angiography showed a right temporal lobe VM with multiple vessels supplying blood. The patient underwent surgery to remove the malformed vessels and the eroded skull. Two hours after the surgery, the patient's right pupil was dilated, and an urgent CT scan of the skull showed a right subdural haematoma under the incision, which was urgently removed by a second operation. After surgery, we gave continuous antibiotic anti-infection treatment, and the patient recovered well and was discharged two weeks later.
Surgical removal of giant haemangiomas is risky and adequate preoperative (including interventional embolisation) and intraoperative preparations should be made.
血管畸形（VMs）是血管生成过程中出现错误的结果，通常在出生时就存在，但可能在出生后才变得明显。然而，头面部巨大VMs并不常见，报道的病例很少，其手术干预的预后尚不清楚。
一名12岁女孩因右侧颞部头皮肿大入院。入院后，脑动脉计算机断层扫描（CT）血管造影显示右侧咬合间隙和右侧颞动脉静脉畸形。此外，脑血管造影显示右侧颞叶VM有多个供血血管。患者接受手术切除畸形血管和被侵蚀的颅骨。手术后两小时，患者右侧瞳孔散大，紧急头颅CT扫描显示切口下方右侧硬膜下血肿，遂紧急进行二次手术将其清除。术后给予持续抗生素抗感染治疗，患者恢复良好，两周后出院。
手术切除巨大血管瘤有风险，应做好充分的术前（包括介入栓塞）和术中准备。
