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罕见头皮动静脉畸形的手术切除:一例报告

Surgical resection of a rare scalp arteriovenous malformation: a case report.

作者信息

Haq Khitamul, Waqas Muhammad A, Akhter Saleem, Cardona Juan J, Scalia Gianluca, Umana Giuseppe E, Chaurasia Bipin

机构信息

Neurological Surgery Neurosurgery, Nishtar Medical University, Multan, Pakistan.

Neurological Surgery Neurological Surgery, Nishtar Medical University, Multan, Pakistan.

出版信息

Ann Med Surg (Lond). 2024 Sep 24;86(11):6805-6809. doi: 10.1097/MS9.0000000000002596. eCollection 2024 Nov.

Abstract

INTRODUCTION AND IMPORTANCE

Scalp arteriovenous malformations (AVMs) are intricate vascular anomalies with abnormal connections between arteries and veins in the scalp, leading to serious complications and cosmetic concerns. Managing scalp AVMs is particularly complex in young female patients, where both functional and aesthetic outcomes are crucial. This case report highlights the successful treatment of a young woman with a scalp AVM, emphasizing the importance of early diagnosis and a multidisciplinary approach.

CASE PRESENTATION

A 30-year-old female presented with a pulsatile scalp mass and significant cosmetic concerns. Diagnostic imaging, including ultrasonography, brain CT scan, MRI, and carotid CT angiogram, confirmed a scalp AVM. The patient underwent a comprehensive treatment plan beginning with endovascular embolization to reduce blood flow to the AVM, followed by surgical resection to remove the lesion. Postoperative follow-up showed a marked reduction in symptoms and lesion volume, with no complications observed.

CLINICAL DISCUSSION

Scalp AVMs, though rare, require prompt diagnosis due to the risk of severe complications such as hemorrhage and cosmetic impact. In this case, a combination of ultrasonography, CT, and MRI provided a detailed assessment of the AVM. A multidisciplinary approach, involving interventional radiology and surgical expertise, was crucial for success. Endovascular embolization minimized intraoperative bleeding and simplified surgical resection, leading to significant symptom and cosmetic improvements. Continuous monitoring is essential for long-term success and early detection of recurrences.

CONCLUSION

This case underscores the effectiveness of a multidisciplinary approach in managing scalp AVMs in young female patients. Early diagnosis through advanced imaging techniques enables timely and targeted intervention. The combined use of endovascular embolization and surgical resection led to significant symptom resolution and aesthetic enhancement. Collaboration among specialists is vital for optimizing outcomes, and ongoing research will further refine treatment strategies, improving the quality of life for patients with scalp AVMs.

摘要

引言与重要性

头皮动静脉畸形(AVM)是复杂的血管异常,头皮内动脉与静脉之间存在异常连接,可导致严重并发症及美容问题。在年轻女性患者中,头皮AVM的治疗尤为复杂,因为功能和美学效果都至关重要。本病例报告强调了对一名患有头皮AVM的年轻女性的成功治疗,突出了早期诊断和多学科方法的重要性。

病例介绍

一名30岁女性因搏动性头皮肿块及严重的美容问题前来就诊。包括超声、脑部CT扫描、MRI及颈动脉CT血管造影在内的诊断性影像学检查确诊为头皮AVM。患者接受了全面的治疗方案,首先进行血管内栓塞以减少流向AVM的血流量,随后进行手术切除以去除病变。术后随访显示症状和病变体积显著减小,未观察到并发症。

临床讨论

头皮AVM虽然罕见,但由于存在出血等严重并发症风险及美容影响,需要及时诊断。在本病例中,超声、CT和MRI相结合对AVM进行了详细评估。多学科方法,包括介入放射学和外科专业知识,对成功治疗至关重要。血管内栓塞减少了术中出血并简化了手术切除,带来了显著的症状改善和美容效果提升。持续监测对于长期成功及早期发现复发至关重要。

结论

本病例强调了多学科方法在年轻女性患者头皮AVM治疗中的有效性。通过先进影像学技术进行早期诊断可实现及时、有针对性的干预。血管内栓塞与手术切除的联合使用导致症状显著缓解和美学改善。专家之间的协作对于优化治疗结果至关重要,持续的研究将进一步完善治疗策略,提高头皮AVM患者的生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c584/11543193/639c5100e529/ms9-86-6805-g001.jpg

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