Case Report: Arteriovenous Malformation Causing Intra-Oral Bleeding of NonDental Origin in a 9 Years Old Female

Profuse and life-threatening haemorrhage may arise from vascular lesions such as Haemangiomas or Vascular malformations (VM) and these differ based on development, endothelial characteristics, aetiological factors, and clinical presentation [1]. Haemangiomas are vascular tumours which arise from rapid and uncontrolled proliferation of endothelial cells at an early stage of embryogenesis, presenting in soft tissues of the oral cavity and rarely involving hard bony structures. Vascular malformations, on the other hand, exhibit a normal endothelial cellular turnover rate but are malformations in the structure of vessels appearing in the late stage of embryogenesis arising from persistent vascular anastomoses. As opposed to the dynamic and active turnover in haemangiomas, VM are present at birth and inherently static in nature, and change in size as body grows, or upon encountering endocrinal changes, trauma or infections. Vascular Malformation can be further subdivided into two categories based on blood flow rate into low-flow lesions (including capillary, venous and lymphatic malformations) or high-flow lesions (such as Arteriovenous malformations [AVM] or fistulae). Approximately half of the cases of Vascular malformations occur in the head and neck region with 50% of the cases involving skull and maxillofacial region [2].