Temporal subcutaneous high-flow arteriovenous malformation

Case contributed by Dr Yaïr Glick

Presentation

Left temporal lump that appeared several weeks earlier and doubled its size in the past week.

Patient Data

Age: 15 years
Gender: Male

Cluster of dilated vessels in the left temporal scalp, with brisk flow exhibiting a substantial flow void. The study does not include MRA, therefore the supplying vessel cannot be established but there is a large vessel descending behind the mandibular angle toward the neck vessels.

For further elucidation by CT angiography.

Left temporal scalp arteriovenous malformation (AVM) supplied by the external carotid artery (ECA) and drained by the external jugular vein (EJV) as well as several tributaries of the facial vein.

Case Discussion

On arriving at the pediatric ER, the left temporal "mass" was noted to be pulsatile.

MRI and CTA showed it to be a high-flow arteriovenous malformation between the external carotid artery (ECA) and the external jugular vein (EJV) as well as facial vein tributaries.

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