Forehead arteriovenous malformation embolization complicated by glue migration into the cavernous sinus: A case report of a rare complication

Background: Arteriovenous malformations (AVMs) are uncommon congenital vascular anomalies characterized by direct, high-flow connections between arteries and veins. Forehead AVMs presents unique challenges due to their aesthetic considerations, risk of complications, and proximity to critical neurovascular structures. Case Presentation: A 26-year-old male presented with a pulsatile forehead swelling present since birth, which gradually increased in size. Doppler ultrasound and MRI revealed a forehead AVM fed by branches from the superficial temporal and ophthalmic arteries, without evidence of intracranial extension. Pre-surgical embolization using cyanoacrylate glue achieved 90% occlusion. However, the procedure was complicated by glue migration into the cavernous sinuses, resulting in headache and dizziness. Management: The patient was initially managed with low-molecular-weight heparin and close clinical observation. Definitive surgical resection was performed successfully one month later. The wound healed without complications, and no recurrence was observed during six months of follow-up. Conclusion: 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.