The value of visual evoked potentials in the evaluation of periorbital hemangiomas.

PURPOSE: To present a case of a child with an extensive facial hemangioma in whom the suspicion of intracranial involvement was raised by visual evoked potential (VEP) evaluation.

DESIGN

Observational case report.

METHODS

VEP analysis was performed using flash and pattern stimuli to determine whether treatment intervention other than occlusion therapy was needed.

RESULTS

VEP analysis indicated a marked transoccipital asymmetry in the flash and pattern VEP suggestive of right hemispheric dysfunction. Neuroimaging showed intracranial extension of the hemangioma.

CONCLUSION

The VEP evaluation is a noninvasive technique performed in the awake child. This case highlights the usefulness of VEP analysis in the management of extensive periocular capillary hemangiomas and its use as a modality to identify potential intracranial involvement. Large plaquelike facial capillary hemangiomas may have possible underlying dural involvement suggestive of PHACES syndrome.