Vascular Anomalies

Question 1

Hemangioma

• Subtypes
• Age at presentation
• Which type growths rapidly?
• Which doesn’t grow after birth?
• Which is most common benign childhood tumor?
• Management

Answer 1

• Subtypes
  
  • Congenital, present at birth, doesn’t grow
  • Infantile, presents sometime after birth, then grows rapidly
• Most common benign childhood tumor = Infantile hemangioma
• Management:
  
  • Intralesional steroids
  • Intralesional bleomycin
  • Propranolol
  • Surgery
    
    • Since the congenital type doesn’t proliferate, only management is to augment involution with surgery,

Question 2

Vascular Malformation

• Age present
• Age when clinically evident
• Growth rate
• Subtypes and common names
• Most common subtype
• Management

Answer 2

• Present at birth, but not noticed until later in life
• Grows same rate as rest of body
• Subtypes
  
  • Capillary = Port-wine stain
  • Lymphatic = Cystic Hygroma (when neck involved)
  • Venous = Most Common
  • Arteriovenous = High Flow
• Management
  
  • Capillary = laser
  • Lymphatic = sclerosis, ABX when infected, surgery
  • Venous = sclerosis, surgery
  • Arteriovenous = Embolize 24-72h prior to surgery (before recanalization)
    *

Question 3

Sturge-Weber Syndrome

• What type of vascular anomaly
• Involved systems
• Management
• Etiology

Answer 3

• Capillary malformation
• Trigeminal distribution
  
  • Max/Mand osseous malformation
  • port-wine stain
  • Gingival hyperplasia
• Leptomeningeal
  
  • Seizures
  • Hemiplegia
  • Cognitive delay
• Ocular choroid
  
  • Rentinal detachment, glaucoma, blindness
• Management
  
  • Face = pulsed dye lasers
  • Anticonvulsants
  • Glaucoma mediation
• Etiology
  
  • Persistence of the vascular plexus around the cephalic portion of the neural tube