Traumatic Arteriovenous Fistula of the Scalp in the Left Tem
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Case Report
A 57-year-old man was diagnosed with paranoid schizophrenia at the age of 20. Eight years prior to presentation in the emergency department, the patient sustained a fist blow to the top of the left temporoparietal region, in a conflict with another patient during treatment in a psychiatric institution. Initially, after the injury, a thumbnail-sized mass developed. It increased in size with time. The patient was therefore hospitalized by his guardian. At presentation an irregular hemispherical mass measuring 8 × 5 × 3?cm was noted in the left temporoparietal area; this mass extended to the forehead and the bottom of the left temple in an earthworm-like form and connected with tortuous vessels from both temporal parts of his head, which were pulsatile. The hemispherical mass was soft and mildly tender and had a moderately elevated temperature. A clear wind-like murmur was heard on auscultation of the mass. Examinations of the heart and lungs and other systemic examinations showed no abnormalities, and laboratory test results were also within normal range. The patient underwent a digital subtraction angiography: the left superficial temporal artery was thickened and tortuous, and there was a large vascular mass at its end....

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4739455/
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