Excision of Large Scalp Arteriovenous Malformations with Aesthetic Scalp Reconstruction

BACKGROUND: Scalp arteriovenous malformations (SAVMs) are seen in young individuals and skin involvement is common in large SAVMs. They are commonly seen in younger age group too. Pre-operative embolization followed by surgical excision and hair bearing scalp reconstruction with tissue expansion are the treatment of choice. Therefore, proper selection of tissue expander for reconstruction of hair bearing scalp, seems essential. This study evaluated excision of large SAVMs with aesthetic scalp reconstruction. METHODS: We described management of 10 patients of large SAVMs with cutaneous involvement. All patients underwent pre-op embolization followed by surgical excision and hair bearing scalp reconstruction with tissue expansion. RESULTS: All cases of large SAVMs healed well with minor complications. CONCLUSION: While complete surgical excision with extirpation of the nidus is considered as the gold standard treatment, aesthetic hair bearing scalp restoration is also of paramount importance for the patient. This is done by using scalp tissue expansion after proper selection of the expander.