Congenital Arteriovenous Fistula Involving the Occipital Artery and Lateral Venous Sinus

The patient, a 47-year-old white woman, was hospitalized complaining of a swishing and throbbing noise in the left ear, corresponding with the heart beat. The symptoms were of several months' duration, without history of trauma. Examinat ion . T h e ear showed no abnormalities, but a loud bruit could be heard in the left temporo-occipital region behind the ear, corresponding with the heart beat. The bruit disappeared on compression of the left carotid artery. Bilateral carotid arteriograms