The pathogenesis of scalp AVM remains unclear. Some clinical experience suggests they might be also associated with a dural AVM or with vascular anomalies of the venous structures of the dura. In all our cases internal carotid angiograms and magnetic resonance scans were performed.
Treatment of scalp AVMs is difficult because of their high shunt flow, complicated vascular anatomy, and cosmetic problems.
The embolization alone could remedy a scalp arteriovenous fistula, without scalp ischemia.
In our cases, transvenous embolization with direct puncture has been very effective using sclerosant liquids or NBCA and circular compression to avoid venous migration.
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