OBJECTIVE Scalp cirsoid aneurysms are subcutaneous arteriovenous fistulae fed by branches of the external carotid artery. They present with progressive scalp swelling and cosmetic deformities in addition to neuro-vascular symptoms. We evaluate the treatment and outcome of this rare vascular lesion with surgery and adjunctive endovascular embolisation performed by a dual-trained neurosurgeon. METHODS A retrospective analysis of 6 cases operated over a 16 year-period was performed which comprised of clinical data, radiology including angiography and pre-operative embolisation, surgical approaches, outcomes and complications. RESULTS 6 patients with ages ranging between 26 and 51 years were operated in the study period. All the patients underwent surgical excision of the lesion, of which 2 had undergone pre-operative embolisation of the feeders. There was no recurrence in the follow-up period (Mean 4.7 years) following total excision of the lesions. One patient had post-operative wound dehiscence and another had migration of embolic material to lungs. CONCLUSION Surgery is the predominant treatment method for scalp cirsoid aneurysms. Various adjunctive endovascular procedures can be performed pre-operatively to minimise operative blood loss.Though lower recurrence is seen with surgery for the scalp AV fistula, embolisation performed in select cases can achieve curative results with appropriate techniques.

中文翻译：

---

头皮环状动脉瘤的现代治疗：双重训练的神经外科医生的观点

目的 头皮环状动脉瘤是由颈外动脉分支供血的皮下动静脉瘘。除了神经血管症状外，他们还表现出进行性头皮肿胀和美容畸形。我们评估了这种罕见血管病变的治疗和结果，手术和辅助血管内栓塞术由受过双重训练的神经外科医生进行。方法 对 16 年间手术的 6 例病例进行回顾性分析，其中包括临床数据、放射学（包括血管造影和术前栓塞）、手术方法、结果和并发症。结果 6 名年龄在 26 至 51 岁之间的患者在研究期间接受了手术。所有患者均行手术切除病灶，其中 2 例行术前输液栓塞术。在病灶完全切除后的随访期内（平均 4.7 年）没有复发。一名患者术后伤口裂开，另一名患者出现栓塞物质迁移至肺部。结论手术是治疗头皮环状动脉瘤的主要方法。可以在术前进行各种辅助血管内手术，以最大程度地减少手术失血量。虽然头皮 AV 瘘的手术复发率较低，但在特定病例中进行的栓塞可以通过适当的技术达到治愈效果。