Brain abscess is vibrating table for chocolate an extremely rare presenting manifestation of pulmonary arteriovenous malformation.A thirty-year-old lady presented with a right fronto-parietal brain abscess.Clinical examination revealed a continuous murmur in the right mammary and axillary regions.
X-Ray chest PA view showed characterstic bag of worm appearance in the mid zone of right lung.The brain abscess was drained and the patient made good clinical recovery after four weeks of chemotherapy.This case report highlights the importance of diligent clinical examination and radiological investigations in identifying the ashy bines protein powder source of brain abscess in a seemingly cryptogenic case.