Surgical management of scalp cirsoid aneurysms: Kuwait experience. (case series)

BACKGROUND: Cirsoid aneurysms are arteriovenous malformations of the scalp region that usually manifest as a painless pulsatile mass. These are present in the younger age group and frequently associated with trauma. OBJECTIVES: Several treatment algorithms have been proposed, and we report our experience with sole surgical management. METHODS: Retrospective review of all the scalp vascular malformation cases performed in the main national Vascular Surgery Service of Kuwait. Pre-operative data, including patient demographics were obtained. All patients underwent diagnostic vascular Duplex ultrasound and angiography. Intra-operative and post-operative data, including outcomes and follow up were recorded. RESULTS: Six patients with Cirsoid aneurysm, four females and two males, had a mean age of 19.7 years (range, 10–33 years). All the patients presented with a painless pulsating mass in the scalp (4 Anterolateral and 2 posterior), and one case had associated dizziness and headache. These malformations were found to be solely fed by the extra-cranial vessels with no intra-cranial communication. One patient had pre-operative embolization prior to excision, and the rest had sole surgical excision. No postoperatively complications or recurrence were seen at 2–5 year follow up. CONCLUSIONS: Cirsoid aneurysms are amenable to sole surgical excision with excellent results after excluding intra-cranial communication.