Direct Puncture Embolization of Scalp Arteriovenous Malformation in a Patient with Severe Hemophilia A: A Case Report

An scalp arteriovenous malformation (AVM) is an abnormal fistulous connection between feeding arteries and draining veins without an intervening capillary bed within the subcutaneous layer. The draining veins are typically grossly dilated and may show variceal dilation that is not life threatening, but can cause cosmetic deformity (1). Hemophilia A, transmitted as an X-linked recessive trait, is a common heritable bleeding disorder caused by mutations in the gene that codes for factor VIII (2). Here, we describe an unusual case of scalp AVM in a patient with severe hemophilia A whom we treated with direct puncture embolization using coils and nbutyl-cyanoacrylate (NBCA), followed by surgical removal.