I read with great interest the paper by Ellis et al. 1The authors retrospectively reviewed the angiographic features of 135 pediatric patients of mean age 10.1 years (range 0–19 years) who were referred to the Hospital for Sick Children in Toronto, Canada and Boston Children’s Hospital over a period of 11 years from 2000 to 2011. The most common presenting symptoms were hemorrhage (64%), seizure (13%) and focal neurological deficits or headache (13%). The authors sought to identify angiographic features associated with arteriovenous malformation (AVM) rupture at presentation. Multivariate logistic regression analysis identified smaller size (p<0.01), exclusive deep …