A Scalp Mass Leading to the Discovery of a Giant Intracranial Arteriovenous Malformation.

Scalp masses are common clinical findings with a broad differential diagnosis, often benign in nature. However, in rare cases, they can be the initial presentation of an underlying intracranial pathology. We report the case of a patient presenting with a painless scalp mass, which led to the incidental discovery of a giant intracranial arteriovenous malformation (AVM). Imaging studies revealed an extensive high-flow vascular lesion with multiple arterial feeders and venous drainage, consistent with a giant AVM. Given the size and complexity of the malformation, a multidisciplinary approach was required for evaluation and management. Giant intracranial AVMs are rare and often diagnosed following neurological symptoms such as seizures, headaches, or hemorrhage. In this case, the scalp mass served as an external marker of a deep-seated vascular anomaly, highlighting the importance of thorough clinical and imaging investigations in atypical presentations. This case emphasizes the need for vigilance when evaluating scalp masses, as they may be the first indication of significant intracranial pathology. Early recognition and appropriate imaging can lead to timely diagnosis and intervention, potentially preventing life-threatening complications.