Ahmed Elshahat
Ain Shams University, Egypt
Posters & Accepted Abstracts: Anaplastology
The arteriovenous malformations of the scalp consist of abnormally connecting arterial feeding vessels and draining veins, devoid of a normal capillary bed within the subcutaneous fatty layer of the scalp. The name "Cirsoid" derived from the Greek word kirsos which means Varix. En bloc excision of scalp tissues affected by the aneurysm is better than selective ligation of feeding and draining vessels. Management of cirsoid aneurysm is an elective procedure and therefore using tissue expanders to create scalp flaps enough to reconstruct the site of the excised lesion is better performed in the 1st stage. Preoperative embolization greatly reduced blood loss during resection. The aim of this work is to present successful management of cirsoid aneurysms of the scalp using tissue expanders, endovascular occlusion and en bloc excision. Five patients presented by cirsoid aneurysms of the scalp (two temporoparietal, two frontal and one occipital). They were managed successfully using three stages intervention. The first is the application of one or two tissue expanders. Expanders were applied under the normal (nonaffected) scalp in the sub-galeal plane. Expansion was performed weekly for 3-4 months. Second stage included endovascular occlusion through endovascular neuroradiology. Third stage was performed the day after occlusion and included en-bloc excision, delivery of tissue expanders and reconstruction of the site of excision using scalp flaps. The postoperative period was uneventiful. Six months to three years follow up showed no recurrence. The conclusion is that the three stages management of large cirsoid aneurysms of the scalp (application of tissue expanders, endovascular occlusion then en-bloc excision and reconstruction) give excellent results.
E-mail: elshahat70@hotmail.com
