Infantile Hemangiomas of the Central Nervous System

Infantile hemangiomas (IH) became a distinct entity differentiated from other vascular lesions in the late twentieth century. There exist several types, including localized, segmental, and indeterminate. These lesions can occur superficially, extend deep into tissues, or can be localized to organs. Most rarely, these can also be discovered as a solitary intracranial lesion or as an intracranial lesion in continuity with an extracranial cervicofacial IH in the posterior fossa-hemangioma-arterial lesions-cardiac abnormalities/aortic coarctation-eye abnormalities/sternal defects and/or supraumbilical raphe (PHACES) syndrome. Treatment most commonly includes the use of beta blockers or corticosteroids and a watching and waiting mentality, although surgical resection may be necessary for a patient who is symptomatic or whose condition is rapidly deteriorating. The surgical treatment of these lesions should be approached extremely conservatively, with extensive preoperative preparation to mitigate the potential blood loss that may ensue. In short, intracranial IH is a unique entity in comparison to the general cutaneous extracranial IH.