Location of port-wine stains and the likelihood of ophthalmic and/or central nervous system complications.
Of 310 patients with port-wine stains, 68% had more than one dermatome involved; 85% had unilateral and 15% had a bilateral distribution of their port-wine stain. At the time of examination, 8% of all patients with trigeminal port-wine stains had evidence of eye and/or central nervous system (CNS) involvement. Extensive involvement, with port-wine stain over the trunk and extremities as well as the head and neck, was observed in 12%. Patients who did not have port-wine stains on the areas served by branches V1 and V2 of the trigeminal nerve had no signs or symptoms of eye and/or CNS involvement. Port-wine stains of the eyelids, bilateral distribution of the birthmark, and unilateral port-wine stains involving all three branches of the trigeminal nerve were associated with a significantly higher likelihood of having eye and/or CNS complications. Twenty-four percent of those with bilateral trigeminal nerve port-wine stains had eye and/or CNS involvement compared with 6% of those with unilateral lesions. All those who had eye and/or CNS complications had port-wine stain involvement of the eyelids; in 91% both upper and lower eyelids were involved, whereas in 9% only the lower eyelid was involved. None of those with upper eyelid port-wine stains alone had eye and/or CNS complications. In addition, 3 (75%) of the 4 subjects with seizures alone had bilateral port-wine stain involvement. A third group, these with unilateral V1, V2, and V3 port-wine stains, had eye and/or CNS complications in 3 (19%) of 16 subjects.(ABSTRACT TRUNCATED AT 250 WORDS)
Tallman
B
B
Laser Center, Boston University Medical Center, Massachusetts.
Tan
O T
OT
Morelli
J G
JG
Piepenbrink
J
J
Stafford
T J
TJ
Trainor
S
S
Weston
W L
WL
D005260:Female; D005901:Glaucoma / Q000150:complications*; D006801:Humans; D008297:Male; D009508:Nevus, Pigmented / Q000150:complications* / Q000473:pathology; D012189:Retrospective Studies; D012640:Seizures / Q000150:complications*; D012878:Skin Neoplasms / Q000150:complications* / Q000473:pathology; D014276:Trigeminal Nerve / Q000473:pathology