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Selective arteriography of the right external carotid artery, showing premature opacification of the right superficial temporal vein, which is dilated and tortuous.
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Arteriovenous fistulae of the superficial temporal artery are rare, and their principal cause is traumas. Complications include pulsatile mass, headache, hemorrhage and deformities that compromise esthetics. Treatment can be performed using conventional surgery or endovascular methods. The authors describe a case of a 44-year-old male patient who d...
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An arteriovenous fistula was diagnosed in a woman with a progressive painful and swollen limb. Ligation of the fistula resulted in decongestion of the limb and reduction of the pain. As the history of trauma or surgery in this case was negative, it is likely the AV fistula is congenital. Résumé Une fistule artério-veineuse a été diagnostiquée chez...
Citations
... Patient may present with various clinical manifestations, such as bruits, tinnitus, local pain, hemorrhage, and disfiguring lesion. [1][2][3] Traumatic arteriovenous fistula is arteriovenous shunting secondary to blunt, penetrating and iatrogenic trauma of artery and vein running in parallel, but rarely occur in the superficial temporal artery. ...
... Arteriovenous fistula of the superficial temporal vessel is a rare condition with incidence of 0.5% to 2.0%; 75% of superficial temporal arteriovenous fistula is caused by blunt, penetrating or iatrogenic trauma. 3,4 In 90% of the patients with scalp arteriovenous fistula, superficial temporal vessel was involved. Several methods, such as open surgical removal, ligation of the feeding trans-vascular embolization, and intra-lesion injection of sclerosant, have been used to treat these cases. 1 As to the knowledge of authors, there were no eports of superficial temporal vessel fistula in Africa. ...
... Spontaneous superficial temporal vessel fistulae may be present congenitally, even though the majority of cases remain asymptomatic until puberty. 3 In general, the most common symptoms of arteriovenous fistula of the scalp are localized headache, a pulsatile subcutaneous mass and pulsatile tinnitus. Physical examination findings are: dilated and tortuous vessel, bruit on auscultation of the mass, pulsatile vibration on palpation, and Terrier's sign. ...
... Patient may present with various clinical manifestations, such as bruits, tinnitus, local pain, hemorrhage, and disfiguring lesion. [1][2][3] Traumatic arteriovenous fistula is arteriovenous shunting secondary to blunt, penetrating and iatrogenic trauma of artery and vein running in parallel, but rarely occur in the superficial temporal artery. ...
... Arteriovenous fistula of the superficial temporal vessel is a rare condition with incidence of 0.5% to 2.0%; 75% of superficial temporal arteriovenous fistula is caused by blunt, penetrating or iatrogenic trauma. 3,4 In 90% of the patients with scalp arteriovenous fistula, superficial temporal vessel was involved. Several methods, such as open surgical removal, ligation of the feeding trans-vascular embolization, and intra-lesion injection of sclerosant, have been used to treat these cases. 1 As to the knowledge of authors, there were no eports of superficial temporal vessel fistula in Africa. ...
... Spontaneous superficial temporal vessel fistulae may be present congenitally, even though the majority of cases remain asymptomatic until puberty. 3 In general, the most common symptoms of arteriovenous fistula of the scalp are localized headache, a pulsatile subcutaneous mass and pulsatile tinnitus. Physical examination findings are: dilated and tortuous vessel, bruit on auscultation of the mass, pulsatile vibration on palpation, and Terrier's sign. ...
Arteriovenous fistulae are abnormal direct communications between artery and venous system. It rarely occurs in superficial temporal vessel and is usually caused by trauma. Clinical manifestation includes pulsatile mass, headache, hemorrhage and tinnitus. Angiography is standard diagnostic modality and surgical removal of the pulsating mass with ligature of the feeding vessel is definitive treatment. The authors describe the case of a 35-year-old female patient who developed a pulsatile tortuous mass, extending from the left preauricular area to the left scalp after sustaining thorn injury (extremely rare penetrating injury). The treatment done was a complete surgical removal of the pulsatile mass and ligature of the feeding superficial temporal artery.
... AVF of the superficial temporal artery is a rare condition, with an estimated incidence of 0.5% to 2.0% of cases. [40] Jatin Bodwal et al. reported a rare case of fatal bleeding from a laceration of superficial temporal artery. The peculiarity of that case lied in the fact that no evidence of fatal accidental superficial temporal artery had ever been reported in the forensic literature. ...
Introduction: Siravedhana, is an important para surgical procedure to withdraw the vitiated blood from body but before performing it the knowledge of Avedhya Sira is mandatory as any injury to these can cause disability or even death. There is total 98 Avedhya Sira in the body. Out of which two are pertaining to the region of Hanu. Any injury to these can cause similar consequences. But the exact location and the structural entity pertaining to it is not clearly mentioned in the classic texts. Material and Methods: Conceptual study carried out by reviewing classical texts, contemporary science, journals, published research works. Conclusion: On the lateral aspect of the head near the anterior margin of the auricle in front of the tragus, the Maxillary artery and Pterygoid venous plexus can be considered as Hanugata Avedhya Sira based on their location and Viddha Lakshana.
... The involvement of the superficial temporal artery, being vulnerable to injury owing to its superficial and long course, occurs in 75% of cases of scalp AVMs but 0.5% to 2.0% of the general population. [4][5][6] Complications include hemorrhage, thrombosis, ulceration and aesthetic complications. 1,4,5 The mass is formed by a system of feeding arteries, which drain directly into veins via arteriovenous fistulae, without an interposed capillary network. ...
... 8 Regardless, proposed mechanisms include (1) simultaneous direct trauma resulting in communication between the walls of veins and arteries in proximity, and (2) the development of small bridging vessels in the arterial vasa vasorum as a result of proliferation of endothelial cells and neovascularization in the healing process. [6][7][8] Vascular malformations may be classified based on their components and properties into high and low flow. With AVMs, the direct relationship between the arteries and veins with an absence of a capillary bed tends to result in a high flow lesion. ...
An arteriovenous malformation is a rare vascular anomaly composed of a complex network of interconnected arteries and veins of the scalp. It is usually congenital, but infrequently occurs after trauma. Over the years, several terms have been used to describe these lesions, such as cirsoid/rasemose/arteriovenous aneurysm, plexiform angioma and aneurysma serpentinum, or arteriovenous fistula when a single connection exists. Head and neck malformations occur in 0.1% of the population. Involvement of the superficial temporal artery is rare, occurring in about 0.5% to 2.0% of cases. They are diagnosed by angiography and can be managed by endovascular or open resection. The case of a 23-year-old man who presented with a pulsatile head mass after blunt trauma 5 years prior is presented. This entity was diagnosed as an arteriovenous malformation supplied by the superficial temporal arteries. He subsequently underwent successful open exploration and resection. The information is presented with the patient's consent.
... For example, three cases For reprints contact: reprints@medknow.com of STA aneurysms are presented Peick and et al. in 1988 [10] and Camargo et al. was described a case of a 44-year-old male patient who developed a large pulsating mass, extending from the preauricular region to the right parietotemporal, and frontal regions after a motorcycle accident in 2014. [11] ...
Most of the vascular lesions on head and neck soft tissue are congenital, but a rare cause can be trauma. A 23-year-old man came to our clinic with a wide pulsatile tortuous mass in the left temporofrontal area. That mass was appeared since 10 years ago. Ten years before his coming to our clinic, he had a blunt trauma in that area. After that, a small wound appeared there and healed gradually. In clinical examination, mass was large and pulsatile, and a fine murmur was detected from it. In paraclinical examination, computed tomography scan with intravenous contrast and sonography revealed a vascular mass with arteriovenous (AV) fistula in soft tissue only in that area. We operated him and vascular mass completely excised without recurrency. Pathologic report was AV malformation (AVM). According to our study, also rare trauma is one of the causes of AVMs, and we able to resection it completely without recurrency.
... The former are traumatic (including iatrogenic trauma) in origin, however sporadic nontraumatic cases are described [8,10]. Traumatic AVF is a rare condition [2]. It develops after accidental trauma of the head or iatrogenic (after certain medical intervention), specifically after temporomandibular joint surgery. ...
... Their endothelium cells divide and form small vascular channels joining the adjacent vein. This process of formation may last up to a year, hence the delayed occurrence of symptomotology [2,3]. ...
We present a case of patient with a rare vessel pathology - arteriovenous fistula (AVF) of superficial temporal artery and vein. The 56-year-old man was admitted to the Department of Neurology because of a headache in the right temporal region with concomitant buzzing sound in his right ear. The pain was present mainly in the evenings and was stronger when touching the temporal region. He denied having any head injury in the last few years. There were no signs of central nervous system involvement in the neurological examination. Within the right temporal area a subcutaneous mass with redness of the surrounding skin and with palpable and audible pulsatile thrill was observed. In computed tomography (CT) of the head no abnormalities were found. In duplex-Doppler ultrasound examination of carotid arteries the systolic blood velocity in the right external carotid artery was over two times higher than in the left one. Its flow profile was turbulent and low-resistant. In CT angiography (CTA) an AVF between superficial temporal artery and vein was revealed - it was located at the level of the right zygomatic arch. In both CTA and magnetic resonance angiography, no abnormal connections between extra- and intracranial vessels were found. The patient underwent surgery with good result - all the symptoms disappeared. AVFs of vessels of the scalp are rare and their aetiology is mainly traumatic or iatrogenic. By describing this case we wanted to draw attention to less frequent causes of headache.
Resumo As fistulas arteriovenosas podem ser congênitas ou traumáticas, sendo as primeiras mais comuns e diagnosticadas na infância e as últimas mais raras e com diagnóstico mais tardio. Ambas necessitam de tratamento intervencionista, que pode ser endovascular ou correção cirúrgica, sendo que cada caso deve ser estudado individualmente. Este artigo apresenta o caso de um paciente de 46 anos, com fístula arteriovenosa na artéria temporal superficial esquerda com suas veias correspondentes decorrente de trauma contuso na região temporal na infância. O diagnóstico foi confirmado por exame de imagem, e o paciente foi submetido a tratamento cirúrgico convencional, apresentando melhora dos sintomas. O caso chama atenção para uma afecção rara, sua investigação diagnóstica e condutas terapêuticas. As fistulas arteriovenosas traumáticas apresentam baixa incidência, ocorrem em variadas localizações e podem causar sintomas, requerendo tratamento, às vezes desafiador, com melhora da qualidade de vida do paciente.
Background:
Scalp cirsoid aneurysms are rare subcutaneous arteriovenous fistulae affecting the scalp. They can be easily misdiagnosed and mistreated.
Objective:
To review reported cases of scalp cirsoid aneurysms for their incidence, etiology, clinical presentation, treatment, and outcomes using an illustrative case.
Methods:
We conducted a PUBMED, SCOPUS, OVID SP, SciELO, and INFORMA search using the keywords; "cirsoid," "aneurysm," "arteriovenous," "malformation," "scalp," "vascular," and "fistula." We identified 74 pertinent papers, reporting 242 cases in addition to our reported index case.
Results:
Median age at presentation was 25 yr (range 1-72 yr); male to female ratio was 2.5:1. The most common symptoms were a pulsatile mass (94% of patients), headaches (25%), and tinnitus (20%). The median duration of symptoms was 3 yr (6 d to 31 yr), with 60.2% occurring spontaneously, 32.23% traumatic, and the rest iatrogenic. A total of 58.5% of cases were managed with surgical excision only, 21.6% with endovascular embolization only, and 14.5% with a combination of both methods. The complication rate observed in the endovascular embolization treatment cohort (55.8%) was significantly higher than that observed in the surgical excision only cohort (9.9%) (P < .00001) and in the combined therapy cohort (0%) (P < .00001). There is a low recurrence rate after treatment irrespective of modality: surgical excision only (6.3%), endovascular embolization only (8.3%), and combined therapy (0%).
Conclusion:
Scalp cirsoid aneurysms are associated with good prognoses when recognized and managed appropriately. We suggest combining surgery with endovascular embolization as the optimum treatment modality.
