A 35 year old male presents with recurrent episodes of spontaneous bleeding from his right ear. He has no significant medical background and takes no regular medications.
He denies tinnitus, hearing loss, trauma, or infective symptoms. On exam he is found to have a small pulsatile cystic lesion on his right antitragus, and his external auditory canal is filled with dried blood.
Following examination he developed persistent haemorrhage from this auditory canal There appears to be a right ear arteriovenous malformation (AVM) arising from branches of the right external carotid artery. There is probably active bleeding occurring posterior to the antitragus at the time of the scan on axial image 340.
Specialist ENT review without undue delay is suggested. The internal and external carotid arteries and vertebral arteries are seen to fill.
No significant stenosis is seen at the origins of the internal carotid arteries. The M1 and M2 branches of the middle cerebral arteries, A1 and A2 branches of the anterior cerebral arteries, posterior cerebral arteries, internal carotid arteries and basilar artery are seen to fill.
LITFL published a clinical update in Critical Care on 11 Feb 2026.
The item focuses on CT Case 103.
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