Surgical Management of Cirsoid Aneurysms of the Scalp: Ten Years’ Experience

Cirsoid aneurysms are rare arteriovenous malformations of the scalp that present with disfigured pulsatile masses and may be associated with headache, bleeding, or tinnitus. These lesions are difficult to manage because of their complex vascular anatomy, high shunt flow, and cosmetic disfigurement; many options have been described to treat such lesions. We evaluate 10 years’ experience in the surgical management of cirsoid aneurysms of the scalp. This study included 15 patients with cirsoid aneurysm of the scalp, all of whom were treated with surgical excision only over 10 years. They were 8 females and 7 males, with a median age of 23 years. History of trauma was present in 5 patients. Frontal and parietal regions were the commonly affected sites. Superficial temporal, supraorbital, and occipital arteries were the most frequent feeding arteries. Excision of the lesion was performed in all patients using our modified surgical technique. All patients had good cosmetic results and there were no recurrences during an average follow-up of 25 months. Despite great progress in endovascular therapy, surgical excision of cirsoid aneurysms of the scalp seems to be the most effective treatment, with good results and patient satisfaction.