Arteriovenous shunts between dural branches of the carotid artery and the cavernous sinus

Three cases with dural arteriovenous shunts of the cavernous sinus are reported. The clinical signs usually were mild and included frontal headache, dilated conjunctival veins, exophthalmos, bruit, and oculomotor nerve palsy. Arterial contributions to the fistulae arose from meningeal branches of the internal and external carotid arteries. The precise diagnosis was made by selective angiography supplemented by subtraction and magnification techniques. The distal occlusion of the feeding arteries close to the shunt offers advantages when compared with conventional vessel ligation because of a more effective exclusion of vascular abnormalities from the circulation.