Infant with heart failure

MRI and MRA and US of intracranial arteriovenous malformation
Axial T2 MRI of the brain (above left) shows large vascular flow voids representing the nidus of the lesion along the right hemisphere of the brain and a dilated sagittal sinus. Sagittal US of the midline of the brain (above right) shows a large vascular structure with mixed arterial and venous flow within it that is compressing and displacing the sagittal sinus beneath it. MR angiogram with contrast of the brain (below left) shows a large nidus of arterial vessels along the right cerebral hemisphere fed primarily by the right middle cerebral artery that rapidly drain into a dilated sagittal sinus on the MR venogram (below right).

The diagnosis was intracranial arteriovenous malformation with arteriovenous fistula.