[Exclusion of an arteriovenous malformation of the left olfactory groove using endo-orbital ligation of the ethmoidal arteries].

A case history of a 59 year old male patient having an intra frontal cerebral hematoma due to a ruptured olfactory groove arteriovenous malformation (AVM) is reported. Following the operative removal of the hematoma, the patient improved steadily and the risk of a recurrent bleeding was considered. A total thrombosis of the AVM was achieved by a two step bilateral transorbital ligation of both anterior and posterior ethmoidal arteries, with no further intracranial approach. The simplicity of this technic is pointed out and its application in other pathological conditions-such as basilar meningiomas in which embolization is hazardous--is suggested. The authors more recently experienced the beneficial effect of transorbital ligation of ethmoidal arteries prior to removal of a highly vascular supra-sellar meningioma.