A 3 years old child’s parents noticed a small swelling on the head at 2 months of age. the swelling increased gradually in size for a year then spontaneously decreased over a year. Following trivial fall, the swelling increased dramatically 3 days prior to presentation. He was otherwise normal.

On examination, the swelling was firm, smooth and pulsatile. No change related to posture or crying was seen.

A CTA was done.

CTA, SSD and MIP images showing the right parietal swelling (hematoma) with a small AVM posteriorly, fed by branches of right superficial temporal artery. the feeders are elevated by the swelling. Also seen are a couple of phleboliths.

The AVM per-se was not filling a lot with contrast, probably partially thrombosed.

The baby was given antiinflammatory drugs and called for AVM excision after the hematoma resolved subsequently.