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        "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Las malformaciones arteriovenosas &#40;MAV&#41; en el cuero cabelludo son lesiones vasculares muy infrecuentes&#46; Sus s&#237;ntomas son variados&#44; desde molestas y antiest&#233;ticas tumoraciones de la piel&#44; hasta hemorragias que pueden ser devastadoras&#46; Su origen puede ser cong&#233;nito o traum&#225;tico&#46; El diagn&#243;stico de las mismas es cl&#237;nico&#44; mediante la inspecci&#243;n del enfermo&#44; y la angiograf&#237;a de las car&#243;tidas interna y externa confirma el diagn&#243;stico&#46; Las posibilidades terap&#233;uticas son variadas&#44; siendo la extirpaci&#243;n quir&#250;rgica el tratamiento de elecci&#243;n&#44; aunque cada vez se utiliza m&#225;s el tratamiento endovascular como tratamiento &#250;nico o prequir&#250;rgico&#44; para disminuir las p&#233;rdidas hem&#225;ticas&#46;</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Presentamos el caso de una paciente de 50 a&#241;os de edad que presentaba una gran tumoraci&#243;n en cuero cabelludo&#44; con dilataciones vasculares muy marcadas y sin otra sintomatolog&#237;a asociada&#46; Describi&#243; un antecedente traum&#225;tico hac&#237;a 12 a&#241;os&#46; La angiograf&#237;a mostr&#243; una MAV abigarrada&#44; con aporte vascular de la car&#243;tida externa y tambi&#233;n de la interna&#44; a cargo de ramas men&#237;ngeas transoseas provenientes de arterias etmoidales y dependientes de ambas arterias oft&#225;lmicas&#46; El tratamiento endovascular de los aportes intracraneales no fue posible&#44; debido al alto riesgo de amaurosis uni o bilateral&#44; por lo que la lesi&#243;n se resec&#243; quir&#250;rgicamente&#44; sin presentarse complicaciones&#46;</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">El tratamiento de las MAV de cuero cabelludo ofrece diversas posibilidades pero se hace imprescindible la individualizaci&#243;n de cada caso a la hora de decidir el abordaje correcto para evitar las posibles complicaciones&#46;</p>"
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        "resumen" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Arteriovenous malformations &#40;AVM&#41; in the scalp are infrequent vascular lesions&#46; Its clinical presentation varies from annoying and unaesthetic mass of the skin to devastating hemorrhages&#46; Its origin can be congenital or traumatic&#46; The diagnosis of AVM is based on physical examination and confirmed by internal and external carotid angiography&#46; Nowadays the gold standard treatment is the surgical intervention although the endovascular approach is gaining field in order to reduce blood losses as presurgical or like lonely treatment&#46;</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">A 50 year old woman was admitted with a huge mass in scalp&#44; with subcutaneous enlarged vessels and no other symptoms&#46; A head traumatic antecedent had occurred 12 years before&#46; The angiography evidenced a mottled AVM with blood supplies from the external and internal carotid arteries&#44; with meningeal transosseous branches from both ophthalmic arteries&#46; Endovascular treatment could not be performed due to high risk of uni- or bilateral amaurosis&#46; Thus&#44; a conventional surgical treatment was done without complications&#46; The treatment of AVM of scalp offers various possibilities but the individualization of each case becomes essential to decide the correct management in order to avoid complications&#46;</p>"
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Vol. 17. Núm. 5.
Páginas 445-449 (enero 2005)
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Vol. 17. Núm. 5.
Páginas 445-449 (enero 2005)
Malformación arteriovenosa gigante de cuero cabelludo: caso clínico
Giant arteriovenous malformation of the scalp. Case report
Visitas
2425
M. García-Conde
, L. Martín-Viota, P. Febles-García, S. Cortés-Franco, A.M. Millán-Corada, M. Spreafico-Guerrero, E. Prada, V. García-Marín
Servicio de Neurocirugía. Hospital Universitario de Canarias. La Laguna. Santa Cruz de Tenerife
Este artículo ha recibido
Información del artículo
Resumen

Las malformaciones arteriovenosas (MAV) en el cuero cabelludo son lesiones vasculares muy infrecuentes. Sus síntomas son variados, desde molestas y antiestéticas tumoraciones de la piel, hasta hemorragias que pueden ser devastadoras. Su origen puede ser congénito o traumático. El diagnóstico de las mismas es clínico, mediante la inspección del enfermo, y la angiografía de las carótidas interna y externa confirma el diagnóstico. Las posibilidades terapéuticas son variadas, siendo la extirpación quirúrgica el tratamiento de elección, aunque cada vez se utiliza más el tratamiento endovascular como tratamiento único o prequirúrgico, para disminuir las pérdidas hemáticas.

Presentamos el caso de una paciente de 50 años de edad que presentaba una gran tumoración en cuero cabelludo, con dilataciones vasculares muy marcadas y sin otra sintomatología asociada. Describió un antecedente traumático hacía 12 años. La angiografía mostró una MAV abigarrada, con aporte vascular de la carótida externa y también de la interna, a cargo de ramas meníngeas transoseas provenientes de arterias etmoidales y dependientes de ambas arterias oftálmicas. El tratamiento endovascular de los aportes intracraneales no fue posible, debido al alto riesgo de amaurosis uni o bilateral, por lo que la lesión se resecó quirúrgicamente, sin presentarse complicaciones.

El tratamiento de las MAV de cuero cabelludo ofrece diversas posibilidades pero se hace imprescindible la individualización de cada caso a la hora de decidir el abordaje correcto para evitar las posibles complicaciones.

Palabras clave:
Malformación arteriovenosa
Aneurisma cirsoideo
Cuero cabelludo
Tratamiento endovascular
Summary

Arteriovenous malformations (AVM) in the scalp are infrequent vascular lesions. Its clinical presentation varies from annoying and unaesthetic mass of the skin to devastating hemorrhages. Its origin can be congenital or traumatic. The diagnosis of AVM is based on physical examination and confirmed by internal and external carotid angiography. Nowadays the gold standard treatment is the surgical intervention although the endovascular approach is gaining field in order to reduce blood losses as presurgical or like lonely treatment.

A 50 year old woman was admitted with a huge mass in scalp, with subcutaneous enlarged vessels and no other symptoms. A head traumatic antecedent had occurred 12 years before. The angiography evidenced a mottled AVM with blood supplies from the external and internal carotid arteries, with meningeal transosseous branches from both ophthalmic arteries. Endovascular treatment could not be performed due to high risk of uni- or bilateral amaurosis. Thus, a conventional surgical treatment was done without complications. The treatment of AVM of scalp offers various possibilities but the individualization of each case becomes essential to decide the correct management in order to avoid complications.

Key words:
Arteriovenous malformation
Cirsoid aneurysm
Scalp
Endovascular treatment

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