Skip to main content
Erschienen in: Pediatric Radiology 9/2011

01.09.2011 | Original Article

PHACE syndrome: MRI of intracerebral vascular anomalies and clinical findings in a series of 12 patients

verfasst von: Jennifer Bracken, Ian Robinson, Aisling Snow, Rosemarie Watson, Alan D. Irvine, David Rea, Ethna Phelan

Erschienen in: Pediatric Radiology | Ausgabe 9/2011

Einloggen, um Zugang zu erhalten

Abstract

Background

PHACE (posterior fossa defects, haemangioma, arterial anomalies, coarctation of the aorta and cardiac defects, eye abnormalities) syndrome describes a constellation of abnormalities that can occur in association with segmental craniofacial infantile haemangioma.

Objective

To report the spectrum of clinical and imaging abnormalities seen in a cohort of children.

Materials and methods

A retrospective review of the clinical and imaging records of all patients diagnosed with PHACE syndrome between 1998 and 2009 was performed. Information sought included patient demographics, craniofacial segments involved, imaging findings and other extracutaneous abnormalities.

Results

Twelve patients were diagnosed with PHACE syndrome over 11 years. All patients had a segmental craniofacial haemangioma. Involved facial segments, in order of frequency, were frontotemporal (12), maxillary (8), mandibular (5) and frontonasal (1). The most common extracutaneous abnormalities were neurovascular anomalies (10), with many patients having multiple anomalies. The spectrum of arterial anomalies ranged from hypoplasia (9) to ectasia (3), anomalous origin/course (2) and persistent fetal anastomosis (2). Other anomalies found included cardiac anomalies (3), coarctation of the aorta (2), posterior fossa malformations (1) and sternal region anomalies (1).

Conclusion

Intracranial anomalies are the most common extracutaneous feature of PHACE syndrome. The contribution of the radiologist in the recognition of such anomalies is important for the diagnosis of PHACE syndrome.
Literatur
1.
Zurück zum Zitat Frieden IJ, Reese V, Cohen D (1996) PHACE syndrome: the association of posterior fossa brain malformations, hemangiomas, arterial anomalies, coarctation of the aorta and cardiac defects, and eye abnormalities. Arch Dermatol 132:307–311PubMedCrossRef Frieden IJ, Reese V, Cohen D (1996) PHACE syndrome: the association of posterior fossa brain malformations, hemangiomas, arterial anomalies, coarctation of the aorta and cardiac defects, and eye abnormalities. Arch Dermatol 132:307–311PubMedCrossRef
2.
Zurück zum Zitat Pascual Castroviejo I (1978) Vascular and nonvascular intracranial malformation associated with external capillary hemangiomas. Neuroradiology 16:82–84PubMedCrossRef Pascual Castroviejo I (1978) Vascular and nonvascular intracranial malformation associated with external capillary hemangiomas. Neuroradiology 16:82–84PubMedCrossRef
3.
Zurück zum Zitat Pascual Castroviejo I, Viano J, Moreno F et al (1996) Hemangiomas of the head, neck, and chest with associated vascular and brain anomalies: a complex neurocutaneous syndrome. Am J Neuroradiol 17:461–471PubMed Pascual Castroviejo I, Viano J, Moreno F et al (1996) Hemangiomas of the head, neck, and chest with associated vascular and brain anomalies: a complex neurocutaneous syndrome. Am J Neuroradiol 17:461–471PubMed
4.
Zurück zum Zitat Metry DW, Garzon MC, Drolet BA et al (2009) PHACE syndrome: current knowledge, future directions. Pediatr Dermatol 26:381–398PubMedCrossRef Metry DW, Garzon MC, Drolet BA et al (2009) PHACE syndrome: current knowledge, future directions. Pediatr Dermatol 26:381–398PubMedCrossRef
5.
Zurück zum Zitat Metry DW, Haggstrom AN, Drolet BA et al (2006) A prospective study of PHACE syndrome in infantile hemangiomas: demographic features, clinical findings, and complications. Am J Med Genet A 140:975–986PubMed Metry DW, Haggstrom AN, Drolet BA et al (2006) A prospective study of PHACE syndrome in infantile hemangiomas: demographic features, clinical findings, and complications. Am J Med Genet A 140:975–986PubMed
6.
Zurück zum Zitat Haggstrom AN, Lammer EJ, Schneider RA et al (2006) Patterns of infantile hemangiomas: new clues to hemangioma pathogenesis and embryonic facial development. Pediatrics 117:698–703PubMedCrossRef Haggstrom AN, Lammer EJ, Schneider RA et al (2006) Patterns of infantile hemangiomas: new clues to hemangioma pathogenesis and embryonic facial development. Pediatrics 117:698–703PubMedCrossRef
7.
Zurück zum Zitat Haggstrom AN, Garzon MC, Baselga E et al (2010) Risk for PHACE syndrome in infants with large facial hemangiomas. Pediatrics 126:e418–e426PubMedCrossRef Haggstrom AN, Garzon MC, Baselga E et al (2010) Risk for PHACE syndrome in infants with large facial hemangiomas. Pediatrics 126:e418–e426PubMedCrossRef
8.
Zurück zum Zitat Oza VS, Wang E, Berenstein A et al (2008) PHACES Association: a neuroradiologic review of 17 patients. Am J Neuroradiol 29:807–813PubMedCrossRef Oza VS, Wang E, Berenstein A et al (2008) PHACES Association: a neuroradiologic review of 17 patients. Am J Neuroradiol 29:807–813PubMedCrossRef
9.
Zurück zum Zitat Kapoor K, Singh B, Dewan LI (2008) Variations in the configuration of the circle of Willis. Anat Sci Int 83:96–106PubMedCrossRef Kapoor K, Singh B, Dewan LI (2008) Variations in the configuration of the circle of Willis. Anat Sci Int 83:96–106PubMedCrossRef
10.
Zurück zum Zitat Uchino A, Nomiyama K, Takase Y et al (2006) Anterior cerebral artery variations detected by MR angiography. Neuroradiology 48:647–652PubMedCrossRef Uchino A, Nomiyama K, Takase Y et al (2006) Anterior cerebral artery variations detected by MR angiography. Neuroradiology 48:647–652PubMedCrossRef
11.
Zurück zum Zitat Park JH, Kim JM, Roh JK (2007) Hypoplastic vertebral artery: frequency and associations with ischaemic stroke territory. J Neurol Neurosurg Psychiatry 78:954–958PubMedCrossRef Park JH, Kim JM, Roh JK (2007) Hypoplastic vertebral artery: frequency and associations with ischaemic stroke territory. J Neurol Neurosurg Psychiatry 78:954–958PubMedCrossRef
12.
Zurück zum Zitat Songur A, Gonul Y, Ozen OA et al (2008) Variations in the intracranial vertebrobasilar system. Surg Radiol Anat 30:257–264PubMedCrossRef Songur A, Gonul Y, Ozen OA et al (2008) Variations in the intracranial vertebrobasilar system. Surg Radiol Anat 30:257–264PubMedCrossRef
13.
Zurück zum Zitat Hess CP, Fullerton HJ, Metry DW et al (2010) cervical and intracranial arterial anomalies in 70 patients with PHACE syndrome. Am J Neuroradiol 31:1980–1986PubMedCrossRef Hess CP, Fullerton HJ, Metry DW et al (2010) cervical and intracranial arterial anomalies in 70 patients with PHACE syndrome. Am J Neuroradiol 31:1980–1986PubMedCrossRef
14.
Zurück zum Zitat Patel SB, Hashmi ZA, Smaroff GG et al (2010) Congenital absence of the left internal carotid artery. Ann Vasc Surg 24:415.e9–415.e11CrossRef Patel SB, Hashmi ZA, Smaroff GG et al (2010) Congenital absence of the left internal carotid artery. Ann Vasc Surg 24:415.e9–415.e11CrossRef
15.
Zurück zum Zitat Karazincir S, Ada E, Sarsilmaz A et al (2004) Frequency of vascular variations and anomalies accompanying intracranial aneurysms. Tani Girisim Radyol 10:103–109PubMed Karazincir S, Ada E, Sarsilmaz A et al (2004) Frequency of vascular variations and anomalies accompanying intracranial aneurysms. Tani Girisim Radyol 10:103–109PubMed
16.
Zurück zum Zitat Heyer GL, Dowling MM, Licht DJ et al (2008) The cerebral vasculopathy of PHACES Syndrome. Stroke 39:308–316PubMedCrossRef Heyer GL, Dowling MM, Licht DJ et al (2008) The cerebral vasculopathy of PHACES Syndrome. Stroke 39:308–316PubMedCrossRef
17.
Zurück zum Zitat Passero SG, Rossi S (2008) Natural history of vertebrobasilar dolichoectasia. Neurology 70:66–72PubMedCrossRef Passero SG, Rossi S (2008) Natural history of vertebrobasilar dolichoectasia. Neurology 70:66–72PubMedCrossRef
18.
Zurück zum Zitat Pico F, Labreuche J, Gourfinkel-An I et al (2006) Basilar artery diameter and 5-year mortality in patients with stroke. Stroke 37:2342–2347PubMedCrossRef Pico F, Labreuche J, Gourfinkel-An I et al (2006) Basilar artery diameter and 5-year mortality in patients with stroke. Stroke 37:2342–2347PubMedCrossRef
19.
Zurück zum Zitat Yilmaz E, Erhan I, Dogan T (1995) Primitive persistent carotid-basilar and carotid-vertebral anastomoses: a report of seven cases and a review of the literature. Clin Anat 8:36–43PubMedCrossRef Yilmaz E, Erhan I, Dogan T (1995) Primitive persistent carotid-basilar and carotid-vertebral anastomoses: a report of seven cases and a review of the literature. Clin Anat 8:36–43PubMedCrossRef
20.
Zurück zum Zitat McKenzie JD, Dean BL, Flom RA (1996) Trigeminal-cavernous fistula: Saltzman anatomy revisited. Am J Neuroradiol 17:280–282PubMed McKenzie JD, Dean BL, Flom RA (1996) Trigeminal-cavernous fistula: Saltzman anatomy revisited. Am J Neuroradiol 17:280–282PubMed
21.
Zurück zum Zitat Ouriel K, Green RM, DeWeese JA (1988) Anomalous carotid-basilar anastomoses in cerebrovascular surgery. J Vasc Surg 7:774–777PubMed Ouriel K, Green RM, DeWeese JA (1988) Anomalous carotid-basilar anastomoses in cerebrovascular surgery. J Vasc Surg 7:774–777PubMed
22.
Zurück zum Zitat Metry DW, Dowd CF, Barkovich AJ et al (2001) The many faces of PHACE syndrome. J Pediatr 139:117–123PubMedCrossRef Metry DW, Dowd CF, Barkovich AJ et al (2001) The many faces of PHACE syndrome. J Pediatr 139:117–123PubMedCrossRef
23.
Zurück zum Zitat Poetke M, Frommeld T, Berlien HP et al (2002) PHACE syndrome: new views on diagnostic criteria. Eur J Pediatr Surg 12:366–374PubMedCrossRef Poetke M, Frommeld T, Berlien HP et al (2002) PHACE syndrome: new views on diagnostic criteria. Eur J Pediatr Surg 12:366–374PubMedCrossRef
24.
Zurück zum Zitat Metry D, Heyer G, Hess C et al (2009) Consensus statement on diagnostic criteria for PHACE syndrome. Pediatrics 124:1447–1456PubMedCrossRef Metry D, Heyer G, Hess C et al (2009) Consensus statement on diagnostic criteria for PHACE syndrome. Pediatrics 124:1447–1456PubMedCrossRef
Metadaten
Titel
PHACE syndrome: MRI of intracerebral vascular anomalies and clinical findings in a series of 12 patients
verfasst von
Jennifer Bracken
Ian Robinson
Aisling Snow
Rosemarie Watson
Alan D. Irvine
David Rea
Ethna Phelan
Publikationsdatum
01.09.2011
Verlag
Springer-Verlag
Erschienen in
Pediatric Radiology / Ausgabe 9/2011
Print ISSN: 0301-0449
Elektronische ISSN: 1432-1998
DOI
https://doi.org/10.1007/s00247-011-2142-z

Weitere Artikel der Ausgabe 9/2011

Pediatric Radiology 9/2011 Zur Ausgabe

Hermes

Hermes

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.