Multimodal surgical approach to complex arteriovenous malformation of the scalp

Abstract

Arteriovenous malformations are vascular anomalies characterized by abnormal connections between arteries and veins, originating from genetic mutations that alter vessel formation. Their management presents a challenge due to their unique behavior in each patient and the high rate ofmorbidityand recurrence. The case of a 21-year-old female with an arteriovenous malformation in the region is described parietotemporooccipital. The left side of the body had been previously treated with a series of embolizations. Upon evaluation, a pulsatile, progressively growing tumor was found in the aforementioned region. A coordinated approach between endovascular therapy and plastic surgery was implemented, achieving selective embolization prior to definitive surgical resection. A wide resection was performed with partial-thickness skin grafting. Postoperative recovery was favorable, with adequate graft integration and a satisfactory functional outcome. The management of arteriovenous malformations requires an individualized strategy based on a comprehensive evaluation. The combination of embolization and resection remains the most effective option for lesion control and complication reduction, especially in complex or recurrent cases.