Open Surgery Following Transarterial Embolization for Cavernous Sinus Dural Arteriovenous Fistula

: Cavernous sinus(CS)dural arteriovenous fistula with cortical venous drainage often have a malignant presentation and require urgent treatment. Endovascular embolization is the primary treatment of choice, but failure to catheterize the CS may occur due to vessel tortuosity, hypoplasia, or stenosis. In the absence of venous access to the lesion, a careful surgical approach should be considered. Here we describe a patient who underwent open surgery following an unsuccessful transvenous embolization due difficulties in venous access.