Background. Unlike those seen in the intracranial circulation, craniofacial high-flow malformations are rare, and no consensus has been reached with regards to its treatment. Embolization has become an integral part of the treatment of these malformations, either alone or in combination with surgical resection.
Case. We present a case of a 37 year old female with a huge facial mass and epistaxis. She was diagnosed with hemangioma and advised excision of the mass. She had an episode of epistaxis and bleeding from her left eye prior to admission. A four vessel angiography showed markedly tortuous bilateral external carotid arteries, arteriovenous malformation with multiple aneurysm formation in the left orbital and periorbital areas. A superselective embolization of the periorbital arteriovenous malformation was done. A week after the embolization, she then underwent wide excision of the Arteriovenous malformation with reconstruction.
Conclusion. For craniofacial arteriovenous malformation, superselective embolization followed by surgical resection may be considered in the management of the lesion.