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.