Learning objectives
Cirsoid aneurysms are rare arteriovenous malformations of the scalp. They are challenging to treat because of their complexity and danger of potential profuse hemorrhage or cosmetic derangement.
A well-rehearsed presurgery radiological mapping of the arteriovenous malformation with exact identification of the feeding artery / arteries and draining veins can substantially reduce these complications.
Although conventional angiography is the gold standard for the diagnosis of arteriovenous pathologies,
Multidetector computed tomography with three dimensional imaging is rapidly being accepted because of its high accuracy and non-invasive nature....
Background
Cirsoid aneurysms are vascular aberrations of the scalp.
The term aneurysm is a misnomer,
as these are actually fistulous connections between feeding arteries and draining veins first described by Brecht in 1833.
These can be either congenital or traumatic in origin.
They are thought to arise during the fetal period as a result of abnormal differentiation of the fetal vasculature with absent capillary bed.
They have a characteristic variceal dilatation of the draining veins.
Various terminologies have been used to describe these lesions,
such as...
Findings and procedure details
Here we are reporting a case series of three patients with arteriovenous malformations of the scalp who presented to our radiology department for CT angiography of brain.
Two of them shared a common previous history of blunt head trauma resulting in progressive development of pulsatile masses on their scalp causing cosmetic deformity.
A 16 slice MDCT is used to perform exams.
Protocol included intravenous Ultravist 100 ml at the rate of 3.0ml/ second.3D CTA images were also acquired.
PATIENT 1: A 32 years old Caucasian...
Conclusion
Evaluation of the angioarchitecture in cirsoid aneurysms is considerably improved with the use of Multidetector computed tomography with cerebral angiography.
The facility of three dimensional image reconstruction and liberty to visualize the abnormal vascular network in any plane has rapidly increased its utilization.
References
1.
Muthukumar N,
Rajagopal V,
Manoharan A,
Durairaj N.
Surgical management of cirsoid aneurysms.
Acta Neurochir (Wien)2002;144:349–56.
2.
Kumar A,
Ahuja CK,
Khandelwal N,
Bakshi JB.
Cirsoid aneurysm of the right pre-auricular region: an unusual cause of tinnitus managed by endovascular glue embolisation.
J Laryngol Otol.
2012 Sep;126(9):923-7
3.
Pukar MM,
Patel IS,
Mewada SG.
Cirsoid aneurysm of scalp occipital region- A case report.
Int J Res Health Sci [Internet].
2014 Apr 30;2(2):698-702
4.
Higashino T,
Mannoji H,
Kawashima M.
Three – dimensional computed tomography...