Traumatic arteriovenous fistula of the superficial temporal vessels: a case for protective headgear when playing squash?

A 35 year old semiprofessional squash player developed the symptoms and signs of an arteriovenous fistula of the left superficial temporal vessels after a squash ball injury. This was sufficiently symptomatic to halt his intensive training programme and required exploration, ligation and excision. Although a rare injury from any cause this would have been prevented by protective headgear.