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      Excision of Large Scalp Arteriovenous Malformations with Aesthetic Scalp Reconstruction

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          Abstract

          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.

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          Scalp arteriovenous malformations.

          Erica S Shenoy, Joseph Raja (2004)
          We discuss our experience with the surgical management of scalp vascular malformation and review the literature on the subject. A prospective case-control study of eight patients with scalp vascular malformations admitted to our hospital between 1997 and 2002. 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. 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. Primary scalp vascular malformation can be excised safely. However, excision of secondary scalp venous dilatation without treatment of the intracranial component can be dangerous.
          Article 0 comments Cited 19 times – based on 0 reviews     Review now
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            Surgical management of scalp arterio-venous malformation and scalp venous malformation: An experience of eleven cases

            Forhad Chowdhury, Mohammod Raziul Haque, Khandkar Kawsar … (2013)
            Aims: Scalp arterio-venous malformation (AVM) and scalp venous malformation (SVM) are rare conditions that usually need surgical treatment. Here, we have reported our experience of the surgical management of such lesions with a short review of the literature. Materials and Methods: In this prospective study, 11 patients with scalp AVM and SVM, who underwent surgical excision of lesion in our hospital from 2006 to 2012, were included. All suspected high-flow AVM were investigated with the selective internal and external carotid digital subtraction angiogram (DSA) ± computed tomography (CT) scan of brain with CT angiogram or magnetic resonance imaging (MRI) of brain with MR angiogram, and all suspected low-flow vascular malformation (VM) was investigated with MRI of brain + MR angiogram. Eight were high-flow and three were low-flow VM. Results: All lesions were successfully excised. Scalp cosmetic aspects were acceptable in all cases. There was no major post-operative complication or recurrence till last follow-up. Conclusions: With preoperative appropriate surgical planning, scalp AVM and SVM can be excised without major complication.
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              Scalp and Forehead Reconstruction.

              Mofiyinfolu Sokoya, Jared Inman, Yadranko Ducic (2018)
              Reconstructing the scalp and forehead is a challenging endeavor frequently undertaken by facial plastic and reconstructive surgeons. There are many anatomical factors to be considered in this area, including multiple neurovascular structure present that should be identified and preserved. Hair morphology and physiology should be considered, and trichophytic techniques should be incorporated into incision planning and closure. The reconstructive ladder must be used when considering options in reconstructing scalps and forehead defects. This article reviews reconstructive options including secondary intention, primary closure, skin grafting, allografts, tissue expanders, and local, regional, and free tissue transfers, among others in the surgical management of forehead and scalp defects. The reconstructive surgeon should be familiar with these techniques and be able to use them when indicated, based on the size, shape, and location of defects.
              Article 0 comments Cited 8 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): World J Plast Surg
                Journal ID (iso-abbrev): World J Plast Surg
                Journal ID (publisher-id): WJPS
                Title: World Journal of Plastic Surgery
                Publisher: Iranian Society for Plastic Surgeons (Tehran, Iran )
                ISSN (Print): 2228-7914
                ISSN (Electronic): 2252-0724
                Publication date (Print): September 2020
                Volume: 9
                Issue: 3
                Pages: 302-308
                Affiliations
                [1 ]Department of Plastic Surgery, Sanjay Gandhi Post-Graduate Institute of Medical Sciences (SGPGIMS), Lucknow, India;
                [2 ]Department of Radiodiagnosis Sanjay Gandhi Post-Graduate Institute of Medical Sciences (SGPGIMS), Lucknow, India
                Author notes
                [* ]Corresponding Author: Ankur Bhatnagar, MCh; Professor of Department of Plastic Surgery, Sanjay Gandhi Post-Graduate Institute of Medical Sciences (SGPGIMS), Lucknow, 226014, India. Tel: +91-9305345897, Email: bhatnagarankur2000@yahoo.com
                Article
                DOI: 10.29252/wjps.9.3.302
                PMC ID: 7734946
                PubMed ID: 33330007
                SO-VID: 6068b26d-d6df-4c89-96b3-0fa27c16e940
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, ( http://creativecommons.org/licenses/by/3.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 19 April 2020
                Date revision received : 3 May 2020
                Date accepted : 10 May 2020
                Categories
                Subject: Original Article

                Keywords: embolization,tissue expansion,arteriovenous malformation,scalp
                Data availability:
                Keywords: embolization, tissue expansion, arteriovenous malformation, scalp

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