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The case of a newborn female in congestive heart failure due to a cerebral A-V fistula is presented. The cardiac manifestations in the presence of this condition are described, and the diagnostic importance of auscultation of the skull is stressed. Because of the precarious condition of most of these neonates, diagnostic procedures should be minimized if the clinical picture is compatible with this diagnosis, and cerebral angiography should be performed before any heart studies are undertaken.
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