Direct Obliteration of Dural Arteriovenous Malformation in the Cavernous Region

Abstract

Three cases of dural arteriovenous malformation (AVM) in the cavernous region were treated by a direct surgical approach. Dural AVMs in these areas are supplied by meningeal branches of both the internal and external carotid arteries. Cavernous sinuses were incised at the lateral wall and packed with oxidized cellulose and EDH adhesive. Hypotension, hypothermia, and temporary clipping of the cervical ICA, were not required during surgery. In one patient packing was not complete, but symptoms improved after 6 months. In the other two cases, dural AVMs were occluded completely; and patency of the internal carotid artery was preserved in all cases.