Bruits and Arteriovenous Malformations

To the Editor.—  Bruits were noted in 12 of 25 patients with angiographically demonstrated arteriovenous malformations (AVMs) encountered in a 15-year period. There was a significant correlation of bruits to both size (larger than 3 × 3 cm in 12 of 14) and duration of symptoms (longer than five years in 11 of 13) in the 23 patients with exclusively supratentorial AVMs (P <.01).Four (one previously reported¹) of five patients with bruits recognized prior to angiographic diagnosis had readily controlled seizures as the only symptom over a 15- to 20-year interval. Two other patients had a first episode of bleeding as long as six and seven years, respectively, after onset of seizures.Cervical, ocular, and cranial auscultation follows palpation of the appropriate pulses. Bone conduction over the cranium and auscultation in the supraclavicular fossa require the diaphragm. An oversized rubber rim for the bell premits an adequate seal