# Forehead Arteriovenous Malformation Embolization Complicated by Glue Migration into the Cavernous Sinus: A Case Report of a Rare Complication

## TL;DR

A 26-year-old man with a forehead arteriovenous malformation faced a rare complication when embolization glue migrated into his cavernous sinus, requiring careful management and successful surgery.

## Contribution

This case report documents a rare complication of glue migration during AVM embolization and emphasizes the importance of multidisciplinary management.

## Key findings

- Embolization with cyanoacrylate glue led to 90% AVM occlusion but caused glue migration into the cavernous sinus.
- The patient was successfully treated with heparin and later surgical resection, with no recurrence after 6 months.
- The case underscores the need to balance embolization risks with therapeutic benefits in AVM management.

## Abstract

Arteriovenous malformations (AVMs) are uncommon congenital vascular anomalies characterized by direct, high-flow connections between arteries and veins. Forehead AVMs present unique challenges due to their aesthetic considerations, risk of complications, and proximity to critical neurovascular structures. A 26-year-old male presented with a pulsatile forehead swelling present since birth, which gradually increased in size. Doppler ultrasound and magnetic resonance imaging (MRI) revealed a forehead AVM fed by branches from the superficial temporal and ophthalmic arteries, without evidence of intracranial extension. Presurgical embolization using cyanoacrylate glue achieved 90% occlusion. However, the procedure was complicated by glue migration into the cavernous sinuses, resulting in headache and dizziness. The patient was initially managed with low-molecular-weight heparin and close clinical observation. Definitive surgical resection was performed successfully 1 month later. The wound healed without complications, and no recurrence was observed during 6 months of follow-up. This case highlights the importance of a multidisciplinary approach in managing AVMs and emphasizes the need to balance embolization risks with therapeutic benefits to achieve optimal outcomes.