Scalp arteriovenous malformations

AIMS: We discuss our experience with the surgical management of scalp vascular malformation and review the literature on the subject.
SETTINGS AND DESIGN: A prospective case-control study of eight patients with scalp vascular malformations admitted to our hospital between 1997 and 2002.
METHODS AND MATERIALS: All the patients were investigated with selective internal and external carotid angiography. Depending upon the origin of feeding arteries, the scalp vascular malformations were classified into two categories: Group I: the primary scalp arteriovenous malformations and Group II: secondary venous dilatations. Six patients belonged to Group I and two patients were in Group II.
RESULTS: Five patients belonging to Group I underwent successful excision of the arteriovenous malformation. There was no recurrence in this group. Of the two patients in Group II, one patient who had scalp vascular dilatation simulating a primary scalp vascular malformation underwent excision of the lesion. This patient developed severe postoperative brain edema and died.
CONCLUSIONS: Primary scalp vascular malformation can be excised safely. However, excision of secondary scalp venous dilatation without treatment of the intracranial component can be dangerous.