Background

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.

Case description

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.

Conclusion

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.

中文翻译：

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新生儿多发性颅内毛细血管瘤自发消退——长期随访及文献复习

背景

颅内毛细血管瘤 (ICH) 的自然病程和行为与颅内海绵状血管瘤非常不同。关于 ICH 的最佳管理策略的文献并不一致。

案例描述

我们的患者是一名 40 天大的男婴，表现为头围进行性增加和多处皮肤毛细血管和 ICH。阻塞性脑积水需要紧急脑脊液 (CSF) 分流，但由于风险与收益比高，没有进行其他手术干预。所有颅内病变在 11 岁时自发消退，尽管速度比皮肤病变慢，没有功能或认知后遗症。我们进行了全面的文献回顾，并提供了所有报告的 ICH 病例的摘要。

结论

由于自发消退的可能性相对较高，因此最好通过密切随访和连续成像研究来处理无症状的 ICH 患者。病灶孤立或诊断不明确的患者可能受益于立体定向活检，手术切除应仅用于有症状的病灶。