Successful Treatment of a Scalp Arteriovenous Malformation With Ulcerative Hemorrhage
A recent case report in WOUNDS details the successful treatment of a rare scalp arteriovenous malformation (AVM) in an 18-year-old male, complicated by ulceration, hemorrhage, and localized alopecia. The condition, initially managed surgically, recurred with worsening symptoms and was ultimately treated through a series of ethanol embolizations and limited, physician-supervised debridement.
Case Summary:
- Initial Presentation: The patient exhibited a pulsatile, erythematous mass on the parietal scalp with hair thinning and repeated bleeding following previous excision.
- Treatment Strategy: Ethanol embolization was performed under DSA guidance to reduce the AVM’s high-flow shunt, followed by staged debridement in a controlled setting.
- Clinical Outcome: Over 18 months and seven treatment sessions, the AVM regressed significantly. The ulcer healed, hemorrhage ceased, and notably, hair regrowth was observed in previously alopecic areas.
- Physiologic Insights: Authors proposed the “steal phenomenon” disrupted follicular perfusion, and resolution via embolization restored scalp blood flow, supporting wound healing and hair regeneration.
Clinical Implications: The case underscores the critical need for careful handling of ulcerated AVMs to prevent hemorrhage and suggests that ethanol embolization, when properly executed, can lead to unexpected functional and cosmetic recovery.
Keywords: Yuxi Chen, Bin Sun, Xi Yang, Chen Hua, Xiaoxi Lin, arteriovenous malformation, ethanol embolization, scalp ulcer, localized alopecia, wound healing