[Extracranial angioma with dural participation]

Area of Science:

• Vascular Surgery
• Neuroradiology
• Pediatric Neurology

Background:

• Extracranial congenital arteriovenous malformations (AVMs) are rare vascular anomalies.
• These AVMs are frequently associated with intracranial anomalies, including cerebral and dural malformations.
• Early diagnosis and management are crucial for preventing complications.

Observation:

• A case of a patient with an extracranial AVM is presented.
• Standard common carotid artery angiography did not reveal intracranial abnormalities.
• Direct injection into an enlarged epicranial vein visualized the extracranial AVM, and phlebography identified a concurrent small dural malformation draining into the superior sagittal sinus.

Findings:

• The case demonstrates that extracranial AVMs can be associated with dural malformations.
• Phlebography, following direct venous injection, successfully identified the dural component.
• Normal carotid angiography does not exclude associated intracranial vascular anomalies.

Implications:

• Comprehensive angiographic evaluation is essential for all patients diagnosed with extracranial AVMs.
• This includes assessing for potential dural and cerebral malformations, regardless of initial carotid imaging results.
• Accurate diagnosis of associated anomalies ensures appropriate treatment planning and improves patient outcomes.