Cirsoid aneurysms are rare arteriovenous malformations of the scalp and extremities.
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Clinical presentation
Patients often present with a slow-growing pulsatile mass and may also experience bleeding, tinnitus and/or a headache 3.
Pathology
Cirsoid aneurysms develop due to an abnormal arteriovenous connection to the superficial veins.
Typically, cirsoid aneurysms of the scalp are fed by the superficial temporal artery only and less commonly they are fed by both superficial temporal and occipital arteries.
Etiology
They are most commonly congenital, although post-traumatic cirsoid aneurysms have been described 1.
Treatment and prognosis
Patients may go on to develop cosmetic defects if left untreated. Treatment options include endovascular occlusion, surgical resection or direct injection of sclerosing agents 2.
History and etymology
They were first described in 1833 by Brecht.
Differential diagnosis
Considerations include 3:
- soft tissue venous malformation (hemangioma)
-
dural arteriovenous fistula with trans-osseous supply
- the superficial component can look identical
- careful evaluation of the superior sagittal sinus for thrombosis
- enlarged feeding meningeal vessels often present
- enlarged draining cortical veins
- sinus pericranii