Emergent Hybrid Treatment of a Ruptured Scalp Arteriovenous Fistula with Eyelid involvement: Technical Note

J Neurol Surg A Cent Eur Neurosurg. 2021 Sep;82(5):490-493. doi: 10.1055/s-0041-1723848. Epub 2021 Apr 12.

Abstract

Background: Scalp arteriovenous fistulas (AVFs) are a rare vascular disease usually presenting as a progressively increasing pulsating mass in the scalp. These lesions can be associated with mild to severe complications, including congestive heart failure. If ruptures, this pathology constitutes a life-threatening medical emergency because of its potential to cause severe bleeding and acute anemia.

Methods: We describe the case of a young woman with a ruptured Yokouchi type C scalp AVF with eyelid involvement.

Results: The patient presented with hypovolemic shock and acute anemia due to severe bleeding from the lesion. Emergent treatment through a combined endovascular and open surgical approach was required to stop bleeding and stabilize the patient.

Conclusions: Emergent and effective treatment is required to stop bleeding when a scalp AVF ruptures. A combination of endovascular embolization and microsurgical excision of the shunt is a treatment option.

Publication types

  • Case Reports

MeSH terms

  • Arteriovenous Fistula* / diagnostic imaging
  • Arteriovenous Fistula* / surgery
  • Embolization, Therapeutic*
  • Eyelids
  • Female
  • Humans
  • Scalp / surgery
  • Treatment Outcome
  • Young Adult