Department of Surgery, University of South Florida Morsani College of Medicine, Tampa, FL, USA.
Department of Neurosurgery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Childs Nerv Syst. 2021 Oct;37(10):3225-3234. doi: 10.1007/s00381-021-05053-7. Epub 2021 Jan 22.
Intracranial capillary hemangiomas (ICHs) have a natural history and behavior that is very different from intracranial cavernous malformations. The literature is not consistent as to the best management strategy for ICHs.
Our patient is a 40-day-old male infant who presented with progressive increase in head circumference and multiple cutaneous capillary and ICHs. Obstructive hydrocephalus necessitated urgent cerebrospinal fluid (CSF) diversion, but no other surgical intervention was pursued due to the high risk-to-benefit ratio. All intracranial lesions spontaneously regressed by 11 years of age, albeit at a slower speed than the cutaneous lesions, with no functional or cognitive sequelae. We conducted a comprehensive literature review and provided a summary of all reported ICH cases.
Asymptomatic patients with ICHs are best approached with close follow-up and serial imaging studies as the potential for spontaneous regression is relatively high. Patients with isolated lesions or unclear diagnoses may benefit from a stereotactic biopsy, and surgical resection should be reserved for symptomatic lesions only.
颅内毛细血管血管瘤（ICHs）的自然病史和行为与颅内海绵状血管畸形非常不同。文献对于 ICHs 的最佳治疗策略并不一致。
我们的患者是一名 40 天大的男性婴儿，因头围逐渐增大和多处皮肤毛细血管和 ICH 而就诊。由于高风险效益比，梗阻性脑积水需要紧急进行脑脊液（CSF）引流，但由于风险效益比高，未进行其他手术干预。所有颅内病变在 11 岁时自发消退，尽管消退速度比皮肤病变慢，但无功能或认知后遗症。我们进行了全面的文献回顾，并对所有报告的 ICH 病例进行了总结。
无症状的 ICH 患者最好通过密切随访和连续影像学研究进行治疗，因为自发消退的可能性相对较高。孤立性病变或诊断不明确的患者可能受益于立体定向活检，仅对有症状的病变进行手术切除。
