Síndrome de Bonnet-Wybur-Mason: dos polos de un espectro / The Bonnet-Wyburn-Mason syndrome: two poles of one spectrum

Se comunican los casos de dos pacientes con síndrome de Bonnet, Wyburn-Mason en quienes existía un aneurisma cirsoide de la retina de diferente grado de desarrollo. En uno, el cuadro oftalmoscópico era obvio; en tanto que en el otro la manisfestación fundamental era una tortuosidad vascular acentuada y en quien solo la angiografía fluoresceínica del fondo ocular mostró sutiles cambios compatibles con una malformación arteriovenosa localizada. Otro elemento inusual en el comportamiento de este tipo de malformaciones fue la asociación a una coartación de la aorta torácica y multiples anomalías esqueléticas sencillas, así como la obstrucción de un segmento muy desarrollado de la malformación arteriovenosa con infarto hemorrágico retiniano e involución posterior de parte de ella

We communicate the cases of two patients with syndrome of Bonnet, Wyburn-Mason who had cirsoide aneurysms of the retina of differnt degrees of development. In one, the ophthalmoscopic picture was obvious, while on the other, The primary manifestation was a marked vascular tortuosity and in which only the ocular fundus fluorescein angiography showed subtle changes consistent with a located arteriovenous malformation. Another unusual element in the behavior of this type of malformations was a coarctation of the thoracic aorta and multiple skeletal anomalies simple associated, as well as the obstruction of a highly developed portion of the retinal arteriovenous malformation with hemorrhagic infarction and consecutive involution of part of it

Tratamento endovascular de aneurismas cirsoideos do couro cabeludo / Endovascular treatment of scalp cirsoid aneurysms

OBJETIVO: Relatar os resultados da aplicação de técnicas endovasculares no tratamento de aneurismas cirsoideos do couro cabeludo. MATERIAIS E MÉTODOS: Quatro pacientes com diagnóstico de aneurismas cirsoideos foram submetidos ao tratamento por via endovascular. Todos os quatro pacientes incluídos nesta série tinham malformações arteriovenosas e foram tratados apenas com embolização. RESULTADOS: Três pacientes foram submetidos a tratamento endovascular mediante embolização transarterial e um foi tratado por punção direta da porção venosa. Os resultados clínicos e cosméticos foram satisfatórios em todos os pacientes. Não houve recidiva clínica durante o período de acompanhamento. CONCLUSÃO: A via endovascular é uma alternativa segura e eficaz no tratamento dos aneurismas cirsoideos. Embora possa ser efetivamente utilizado como uma alternativa adjuvante ou complementar à cirurgia, especialmente quando é necessário lidar com aferências profundas, a maioria dos casos pode ser totalmente curada apenas com a terapêutica endovascular. A escolha do método de tratamento deve ser baseada em uma variedade de características próprias da lesão, incluindo sua angioarquitetura, tamanho e apresentação clínica.

OBJECTIVE: To report results of the application of endovascular techniques in the management of scalp cirsoid aneurysms. MATERIALS AND METHODS: Four patients diagnosed with cirsoid aneurysms were submitted to treatment by endovascular approach. All the four patients included in the present series had arteriovenous malformations and were treated solely by embolization. RESULTS: Three of the patients underwent endovascular treatment by transarterial embolization and one was treated by direct puncture of the venous segment. Both clinical and cosmetic outcomes were satisfactory in all of the patients. Clinical relapse was not observed along the follow-up period. CONCLUSION: The endovascular approach is safe and effective in the management of crisoid aneurysms. Although this technique can be used as an adjuvant or complement to surgery, particularly in cases where deep afferents are involved, complete resolution can be achieved only with endovascular treatment. The choice of treatment method should be based on a range of typical characteristics of the lesion, including angioarchitecture, size and clinical presentation.

Traumatic Cirsoid Aneurysm of the Scalp Diagnosed by Doppler Ultrasonography: Case Report

The authors report a patient with a small traumatic cirsoid aneurysm of the scalp, diagnosed by duplex doppler ultrasonography. This 15-year-old boy was diagnosed as a cirsoid aneurysm by duplex doppler ultrasonogram which revealed an ovoid cystic lesion at left temporal area of scalp containing vascular flow mapping. The gross appearance showed an aneurysm with arteriovenous fistula, consisting of two feeding arteries and two draining veins. Total removal of mass was made and the histological examination revealed an aneurysm which showing irregular contour of inner surface and thickened fibrotic vascular wall without normal arterial layers. Noninvasive duplex doppler ultrasonography before surgical excision or direct puncture embolization of cirsoid aneurysms of the scalp could be recommended as an alternative management option.

Cirsoid Aneurysms of the Scalp: Report of Three Cases

The arteriovenous fistula and cirsoid aneurysm, characterised by abnormal arterial and venous connections with grossly dilated and expansile mass of vessels, may predispose to dramatic complications. Cirsoid aneurysms of the scalp have been reported to be difficult to remove. Multiple treatment schemes have been described and, as yet, no standard form of therapy exists. Three cases of cirsoid aneurysms of the scalp are presented. Each of them was treated with embolization and total excision after ligation of the feeding arteries. All of them were well cured.

Excision of a Cirsoid Aneurysm of the Scalp after Proximal Ligation of the Main Feeder: Case Report

Cirsoid aneurysm of the scalp is difficult to manage because of complicated vascular anatomy and massive intraoperative hemorrhage. The authors report a patient in whom a large cirsoid aneurysm of the scalp was eliminated by excision after proximal ligation of the main feeder. Where possible, total excision followed by proximal ligation of feeders may be a effective ablative technique to manage cirsoid aneurysm of the scalp.

Cirsoid Aneurysm of the Scalp: Case Report

The authors report a case of cirsoid aneurysm in which diagnosis is reached by carotid angiography. To clarify the confusion regarding this rare lesion, the definition, origin and pathogenesis of the lesion are discussed.