Fath L, Simon F, Levy R, Boccara O, Couloigner V. Dangers and therapeutic difficulties of intracranial hemangioma in infants: A CARE case report.
Eur Ann Otorhinolaryngol Head Neck Dis 2024:S1879-7296(24)00018-8. [PMID:
38395664 DOI:
10.1016/j.anorl.2024.02.001]
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Abstract
INTRODUCTION
Description of neurological complications induced by intracranial hemangioma in infants and by the initiation of beta-blocker treatment (propranolol).
OBSERVATION
A 2-month-old infant was referred for grade 5 non-congenital unilateral peripheral facial palsy. Work-up revealed ipsilateral profound hearing loss and two intracranial hemangiomas: one in the ipsilateral internal auditory canal (IAC), the other in the cerebellum opposite the nodule of vermis. Initial treatment with a beta-blocker (propranolol 1mg/kg/day for 1month, then 3mg/kg/day) resulted in disappearance of symptoms and regression of lesions within 8weeks. At 20months after introduction of maintenance therapy (propranolol 3mg/kg/day), two asthma attacks occurred, leading to initiation of fluticasone and continuation of the beta-blocker. Thirty months after discontinuation of treatment, no further progression was noted.
DISCUSSION
Unilateral facial palsy in an infant suggests a number of diagnoses. MRI revealed IAC hemangioma. The choice of dosage and duration of treatment was based on a review of the literature and a strategy defined in multidisciplinary consultation.
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