Emergent medical and surgical management of mediastinal infantile hemangioma with symptomatic spinal cord compression: Case report and literature review

Daniel H. Fulkerson, Nnenna G. Agim, George Al-Shamy, Denise W. Metry, Shayan A. Izaddoost, Andrew Jea

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

Purpose: We report an extremely rare case of a patient with a large, cervical, and upper thoracic cutaneous hemangioma associated with a separate, underlying mediastinal hemangioma extending to the epidural space causing significant spinal cord compression. Case report: A 6-week-old female presented with decreased movement of her right arm and bilateral lower extremity hyperreflexia. Her arm weakness progressed to paralysis over the course of 24 h. She underwent emergent surgical decompression and medical therapy with propranolol and systemic corticosteroids. Conclusion: While several recent reports have described dramatic responses of hemangiomas to propranolol, this is the first case in which it was used as part of a multimodal approach to symptomatic spinal cord compression. The infant improved immediately after surgery. She is neurologically intact and has radiographic regression of the hemangiomas on follow-up examination 6 months later.

Original languageEnglish (US)
Pages (from-to)1799-1805
Number of pages7
JournalChild's Nervous System
Volume26
Issue number12
DOIs
StatePublished - Dec 2010

Keywords

  • Infantile hemangioma
  • Myelopathy
  • Pediatric spine
  • Propranolol

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Clinical Neurology

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