Post-traumatic cirsoid aneurysm

Case contributed by Monica Morales Monzón
Diagnosis certain

Presentation

History of a head contusion, presented with a persistent headache associated with a growing and pulsating bulge.

Patient Data

Age: 20 years
Gender: Male

Arteriovenous malformation of the left parietal superficial cranial region, composed of multiple arteriovenous fistulas dependent on the left external carotid system and epicranial veins tributaries of the internal jugular vein on the same side, with no apparent connection to the intracranial vessels, it is also observed some dilated tortuous nutritional vessels peripheral to the lesion, with a 12 mm diameter in the most dilated vascular structure. The lesion causes a mass effect at the level of the soft tissues of the scalp.

Case Discussion

Post-traumatic cirsoid aneurysms of the scalp are rare, generally occurring due to arteriovenous shunts, within the scalp, between the external carotid artery and the scalp veins. The superficial temporal artery is the most commonly involved, and the occipital artery is less frequently. Clinical manifestations may include a continuous loud murmur, hemorrhage, a throbbing headache, and in severe cases necrosis of the scalp.

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