Right internal carotid artery: from the left A2 segment, a tortuous pericallosal branch is visualized feeding the nidus in the insular area; drainage is seen through an ectatic superficial Sylvian vein draining into the transverse sinus.
Left internal carotid artery: demonstration of a large AVM. The feeding arteries are seen from the lenticulostriate branches to the inferior component, and from the enlarged superior division branches of the MCA to the rest of the AVM. There is rapid venous shunting to a superficial middle cerebral vein, and eventually to the vein of Labbe and the transverse sinus. There is no definite evidence of draining to the internal venous system.
Successful embolization of the medial part, supplied from ACA branches, of the left insular AVM nidus was achieved.