[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-416240-105":59,"doc-detail-416240-en":131},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":124,"head_meta":126,"extra_data":128,"updated_unix":130},105,"en","management-of-a-scalp-arteriovenous-malformation-in-a-lower-middle-income-country-a-case-report","Management of a scalp arteriovenous malformation in a lower-middle income country - A case report","","Spontaneous scalp arteriovenous malformations are rare and often detected only when they become problematic in adulthood. A 35-year-old man with a congenital, progressively enlarging occipital scalp AVM presented with worsening headaches and behavioral changes. CT and CT-angiography demonstrated a right-sided occipital contrast-enhancing mass supplied by the right occipital artery. Digital subtraction angiography and pre-operative embolization were not beneficial, and surgical excision alone achieved complete removal, despite intra-operative bleeding 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[https://doi.org/10.7461/jcen.2025.E2025.04.002](https://doi.org/10.7461/jcen.2025.E2025.04.002)  \nNeurosurgery   \nManagement of a scalp arteriovenous malformation in a lower-middle income country: A case report  \nDaoudaWague1, Ebrima Kalilu Manneh1,2, Mbaye Thioub1, Maguette Mbaye1, Aissatou Kébé1, Hugues Ghislain Atakla1  \n1Department of Neurosurgery, Fann National University Hospital, Dakar, Senegal  \n2Neurosurgery Unit, Department of Surgery, Edward Francis Small Teaching Hospital, Banjul, The Gambia  \nJ Cerebrovasc Endovasc Neurosurg. 2025 December;27(4):346-353  \nReceived: 5 April 2025  \nRevised: 28 May 2025  \nAccepted: 28 May 2025  \nCorrespondence to  \nEbrima Kalilu Manneh  \nNeurosurgery Unit, Department of Surgery, Edward Francis Small Teaching Hospital, Independence Drive, Banjul, The Gambia, West Africa  \nTel +2203400774  \nE-mail [emanneh16@gmail.com](emanneh16@gmail.com)  \nORCID [https://orcid.org/0009-0008-1036-3354](https://orcid.org/0009-0008-1036-3354)  \nThis is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ([http://creativecommons.org/licenses/](http://creativecommons.org/licenses/)[ ](http://creativecommons.org/licenses/)[by-nc/4.0/](by-nc/4.0/)) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.  \nSpontaneous scalp arteriovenous malformations (AVMs) are often present at birth but are usually noticed when they cause aesthetic problems in adulthood. Concerning treatment; there has been a shift towards endovascular treatment alone or in combination with surgical resection. In developing countries, endovascular options might not be readily available. We hereby report a case of a large spontaneous scalp AVM managed successfully via surgical excision only. A 35-year-old man presented with a large pulsating mass located in the occipital region of the scalp. This mass had been present from birth and had been growing over the years. Computed tomography (CT) scan and CT-angiography showed an occipital, contrast-enhancing mass, mostly lateralized to the right and fed by the right occipital artery. The patient did not benefit from digital subtraction angiography or pre-operative embolization. An indication for surgical excision was made. The first step was geared at controlling hemorrhage which was only partially effective due to another feeder that was missed on the CT-angiography. The second step involved dissecting and de-vascularizing the lesion. Complete excision of the AVM was achieved along with excision of the adjacent galea. Management of large scalp AVMs is possible even in resource strained environments. Knowledge of the behavior of feeders regarding lateral or midline disease, coupled with meticulous interpretation of available imaging, is essential in planning surgery. Intra-operative bleeding can be controlled by early temporary clipping or ligation of the main feeders and then one can proceed with the surgical resection.  \nKeywords Arteriovenous malformation, Blood loss, Developing countries, Scalp, Surgical Procedures  \nINTRODUCTION  \nScalp arteriovenous malformations (AVMs) are very rare vascular anomalies. A prevalence of 200 cases over 15 years worldwide has been reported; they are also reported to account for 8. 1% of all arteriovenous malformations. 1)3)9)10)15)18)22)23) The first accurate description was provided by Hunter in 1757. The case presented in this  \n346 [www.the-jcen.org](www.the-jcen.org) Copyright © 2025 by KSCVS and KoNES  \npaper is the third scalp AVM managed at our center but the first of a large scalp AVM. Scalp AVMs are also called “cirsoid aneurysms” meaning varix, due to the serpentine shape of the draining veins.2)13)18) This pathology is characterized by an abnormal connection b","cbCaitZXBXJtcUwO","https://ap.wps.com/l/cbCaitZXBXJtcUwO","pdf",2672919,"English","# Introduction\n# Case description\n# Management and surgical outcome\n# Discussion and clinical implications","[{\"question\":\"Why is a scalp arteriovenous malformation often noticed later in life?\",\"answer\":\"Spontaneous scalp AVMs are often present at birth but are usually noticed when they cause aesthetic problems or other functional concerns in adulthood.\"},{\"question\":\"What imaging findings guided treatment in this case report?\",\"answer\":\"Computed tomography and CT-angiography showed an occipital, contrast-enhancing mass mostly lateralized to the right and fed by the right occipital artery.\"},{\"question\":\"How was the patient’s large scalp AVM managed, and what was the result?\",\"answer\":\"The team proceeded with surgical excision only, using early steps to control hemorrhage and then dissecting and de-vascularizing the lesion, achieving complete excision including removal of adjacent galea.\"}]","Management of a scalp arteriovenous malformation in a lower-middle income country - A case report | PDF",1790604694]