Malformaciones vasculares segmentarias faciales

Journal Scan / Research · September 19, 2019

Cerebrovascular Anomalies in Children With Segmental Facial Hemangiomas

The British Journal of Dermatology

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• In this study, the authors retrospectively assessed the prevalence of cerebrovascular anomalies on MRI along with magnetic resonance angiography in 58 children with segmental facial hemangiomas (SFH) <5 cm (n = 31) versus ≥5 cm (n = 27). Cerebrovascular anomalies (CVA) were found in 36% (n = 21) of patients in the overall cohort, and, of these, 19 involved the circle of Willis. CVA was found in 6 of 31 (19%) with SFH <5 cm and 15 of 27 (56%) with SFH ≥5 cm (P<.01).

• These findings indicate that the prevalence of cerebrovascular anomalies was positively correlated with the size of the segmental facial hemangiomas. These findings also challenge current recommendations that MRI screening should only be performed for SFH >5 cm in size, as nearly 20% of smaller lesions were associated with anomalies.

– Caroline Crabtree, MD

Abstract 

The aetiology of infantile haemangiomas is still not fully understood. The hypothesis of tissue hypoxia was corroborated by children presenting with large segmental facial haemangioma (SFH) in association with ipsilateral cerebrovascular and/or cervicovascular (CVA) anomalies. PHACE syndrome (posterior fossa malformations, haemangioma, arterial, cardiac, eye and/or sternal anomalies; OMIM 606519) is diagnosed in about 31% of all children with large facial haemangiomas. Most children have only one extracutaneous manifestation. CVA anomalies were reported in up to 91% of all patients with PHACE. Blood‐flow limiting CVA anomalies confer a risk of arterial ischaemic stroke.2 CVA anomalies are thus the most prevalent and relevant extracutaneous manifestations of PHACE syndrome.

The British Journal of Dermatology

Risk of Associated Cerebrovascular Anomalies in Children With Segmental Facial Haemangiomas

Br J Dermatol 2019 Jun 25;[EPub Ahead of Print], F Schmid, M Reipschlaeger, A Leenen, PH Hoeger 

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Benjamin Hidalgo-Matlock
Skin Care Physicians of Costa Rica

Clinica Victoria en San Pedro: 4000-1054
Momentum Escazu: 2101-9574

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