Spontaneous scalp arteriovenous fistula in a child with hartnup disease.
OBJECTIVE
To report the endovascular treatment of a spontaneous scalp arteriovenous fistula (AVF) in a child with Hartnup disease.


METHODS
A 6-year-old girl with Hartnup disease presented with recurrent attacks of intense, migraine-like, right-sided headache; a tender, pulsatile small mass was observed in the scalp. Selective digital subtraction angiography revealed a high-flow scalp AVF fed by the frontal branch of the right superficial temporal artery draining via the scalp veins. Endovascular treatment was performed by direct puncture of the distal feeding artery and injection of 2 mL of a 50% mixture of N-butyl-cyanoacrylate and Lipiodol. Serial arteriograms performed 6 months and 2 years later documented complete resolution of the lesion. The patient has had no recurrence of clinical symptoms or local signs for recanalization.


CONCLUSIONS
Scalp AVFs may progress in size, causing significantly disabling symptoms, particularly in children. We recommend endovascular treatment at the earliest possible stage.
Kim
Doris Maria
DM
Department of Maxillo-Facial Surgery, Charité, Humboldt University, Berlin, Germany.
Benndorf
Goetz
G
Von Moers
Arpad
A
Campi
Adriana
A
Lehmann
Thomas-Nicolas
TN
D000792:Angiography; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging / Q000628:therapy*; D002648:Child; D004621:Embolization, Therapeutic; D004659:Enbucrilate / Q000627:therapeutic use; D005260:Female; D006250:Hartnup Disease / Q000150:complications* / Q000000981:diagnostic imaging; D006801:Humans; D010690:Phlebography; D012535:Scalp / Q000098:blood supply*; D013699:Temporal Arteries / Q000000981:diagnostic imaging; D014014:Tissue Adhesives / Q000627:therapeutic use; D016896:Treatment Outcome
D014014:Tissue Adhesives; D004659:Enbucrilate