Scalp Arteriovenous Malformation with Concomitant, Flow-Dependent Malformation and Aneurysm

Area of Science:

• Neurology
• Vascular Surgery
• Pediatric Neurosurgery

Background:

• Scalp arteriovenous malformations (sAVMs) are congenital vascular anomalies.
• Co-occurrence with other vascular pathologies complicates management strategies.

Observation:

• A 21-year-old male presented with a pulsatile scalp mass and bruit.
• Imaging revealed a right sAVM, an intracranial vascular anomaly fed by an azygos anterior cerebral artery (ACA), and a distal ACA aneurysm.
• A schizencephalic developmental anomaly was also noted.

Findings:

• The sAVM was treated with embolization and surgical resection.
• The intracranial vascular anomaly and ACA aneurysm were managed surgically.
• The patient recovered well without neurological deficits.

Implications:

• This case highlights a unique and complex combination of vascular and developmental anomalies.
• Management strategies for sAVMs must consider co-existing intracranial pathologies.
• Further research is needed to establish standard treatment protocols for such rare presentations.