Intraorbital arteriovenous malformation: issues in surgical management

Intraorbital arteriovenous malformations are infrequent but, when present, typically require complex surgical management. Computed tomography and magnetic resonance imaging help characterize lesion structure, location, and relationship to intraorbital anatomy. Frequently complex, intervention should be prompted by significant proptosis, increased intraocular pressure, pain, bleeding, ulceration, or high-output cardiac complications. For more controlled surgical debridement, angiographic embolization may help occlude the nidus and feeding vessels temporarily. Utmost caution must be taken to avoid injury to the optic nerve and ophthalmic artery. We present a rare case of complex, intraorbital arteriovenous malformation, as well as discuss aspects of management and relevant literature.