Haine Elsa, Sevely Annick, Boetto Sergio, Delisle Marie-Bernadette, Cances Claude
Unité de Neurologie Pédiatrique, Hôpital des Enfants, CHU Purpan, Toulouse, France.
Unité de Neuroradiologie Diagnostique et Thérapeutique, Pôle imagerie médicale, Hôpital Pierre-Paul Riquet, CHU Purpan, Toulouse, France.
Neuropediatrics. 2017 Oct;48(5):378-381. doi: 10.1055/s-0037-1599235. Epub 2017 Mar 16.
A 21-day-old male infant was admitted with signs of intracranial hypertension. Brain magnetic resonance imaging (MRI) revealed a voluminous mass in the posterior fossa with an intense peripheral enhancement on T1 images with gadolinium. The child was treated secondarily by surgical decompression of the posterior fossa and the lesion was biopsied. The pathological findings indicated infantile hemangioma. Treatment with oral prednisolone was initiated at 3 months, given the lack of tumor involution. Six months after corticotherapy was stopped, repeated MRIs indicated a significant reduction in tumor size and then complete disappearance. Psychometric evaluation was performed at the age of 15 years, showing heterogeneous cognitive disabilities, with verbal abilities superior to nonverbal abilities and delayed motor development. Neurological examination was normal with no focal deficit. To our knowledge, this is the first published case reporting the long-term evolution of a patient with neonatal intracerebral hemangioma. We conclude that psychometric evaluations should be part of the long-term follow-up of children who have had an intracranial capillary hemangioma.
一名21日龄男婴因颅内高压症状入院。脑部磁共振成像(MRI)显示后颅窝有一个巨大肿块,钆增强T1图像上有强烈的周边强化。该患儿接受了后颅窝手术减压的二期治疗,并对病变进行了活检。病理结果显示为婴儿血管瘤。由于肿瘤未消退,3个月时开始口服泼尼松龙治疗。停止皮质激素治疗6个月后,重复MRI显示肿瘤大小显著缩小,随后完全消失。患儿15岁时进行了心理测量评估,结果显示存在异质性认知障碍,语言能力优于非语言能力,运动发育延迟。神经系统检查正常,无局灶性缺损。据我们所知,这是首例发表的报告新生儿脑内血管瘤患者长期病情演变的病例。我们得出结论,心理测量评估应成为颅内毛细血管瘤患儿长期随访的一部分。