A Case of Scalp Arteriovenous Malformation Treated by Transvenous Embolization Using Onyx

OBJECTIVE: We treated a case of scalp arteriovenous malformation (sAVM) by transvenous embolization using Onyx. CASE PRESENTATION: We describe the case of a 17-year-old woman with a pulsatile mass at the right temporal area. DSA identified sAVM with the venous pouch between the right occipital artery (OA) and the right two occipital veins (OVs), which was also fed by multiple branches of the right posterior auricular artery (PAA) and superficial temporal artery (STA). The shunts were completely occluded by the reverse pressure cooker technique (RPCT), which involves navigating the balloon catheters just distal to the shunt point in the OVs approaching from the right external jugular vein (EJV) and injecting Onyx to each feeder retrogradely with balloons inflated. CONCLUSION: This technique may be useful for treating sAVM with venous angioarchitecture enabling a transvenous approach.