Arteriovenous malformation or contusion : a diagnostic dilemma.

A young man was involved in a motor vehicle accident and sustained cerebral contusion in the right frontal and occipital lobes. Computed tomography (CT) scan done 2 weeks after the injury revealed multiple serpenginous structures which enhanced following intravenous contrast media administration. The possibility of arteriovenous malformation (AVM) was raised and angiography was suggested. However, he was managed conservatively and a repeat CT scan 4 months post trauma revealed encephalomalacia in the right frontal and occipital lobes with no more surrounding enhancement. The cause for the multiple serpenginous enhancement demonstrated previously confirmed those are areas of hyperperfusion in healing surface brain contusion. The aim of this case report is to discuss on the possible causes of focal enhancement following head injury versus the features of AVM on plain and post contrast CT scan with the effort to clear the doubt and to avoid future confusion.