Three children, ages 5 to 9 years, with A-V malformations that ruptured after trivial head trauma, are reported from the Departments of Neurosurgery, University Medical School and Red Cross Hospital, Kumamoto City, Japan. They represented 12% of 25 consecutive patients with proven AVM’s and 30% of 10 patients under 15 years of age. Two received blows on the forehead and one on the occipital region. Intracerebral hematomas were located in the sub-cortical area of the parietal or temporal lobe. Cerebral angiography revealed AVM’s with feeding arteries from the anterior or middle cerebral arteries. At surgery there was no evidence of cortical contusion and excision of the AVM’s was successful. 
COMMENT. The authors found only 7 other case reports in the literature where hemorrhage from an AVM was associated with head trauma. All were in children. It is suggested that a larger shearing force can be produced in a child’s brain than in an adult’s, particularly during acceleration of the head in the AP or PA direction.