title: Emergent medical and surgical management of mediastinal infantile hemangioma with symptomatic spinal cord compression: case report and literature review.
abstract: OBJECTIVE
  We report an extremely rare case of a patient with a large, cervical, and upper thoracic cutaneous hemangioma associated with a separate, underlying mediastinal hemangioma extending to the epidural space causing significant spinal cord compression.
  
  
  METHODS
  A 6-week-old female presented with decreased movement of her right arm and bilateral lower extremity hyperreflexia. Her arm weakness progressed to paralysis over the course of 24 h. She underwent emergent surgical decompression and medical therapy with propranolol and systemic corticosteroids.
  
  
  CONCLUSIONS
  While several recent reports have described dramatic responses of hemangiomas to propranolol, this is the first case in which it was used as part of a multimodal approach to symptomatic spinal cord compression. The infant improved immediately after surgery. She is neurologically intact and has radiographic regression of the hemangiomas on follow-up examination 6 months later.
authors.affiliation: Division of Pediatric Neurosurgery, Texas Children's Hospital, Baylor College of Medicine, 6621 Fannin Street, CCC 1230.01, 12th Floor, Houston, TX 77030, USA. d_fulkers@hotmail.com
authors.forename: Daniel H
authors.initials: DH
authors.lastname: Fulkerson
authors.forename: Nnenna G
authors.initials: NG
authors.lastname: Agim
authors.forename: George
authors.initials: G
authors.lastname: Al-Shamy
authors.forename: Denise W
authors.initials: DW
authors.lastname: Metry
authors.forename: Shayan A
authors.initials: SA
authors.lastname: Izaddoost
authors.forename: Andrew
authors.initials: A
authors.lastname: Jea
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use; D002675:Child, Preschool; D019299:Decompression, Surgical / Q000009:adverse effects*; D005260:Female; D018324:Hemangioma, Capillary / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D008479:Mediastinal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000188:drug therapy / Q000209:etiology; D011239:Prednisolone / Q000627:therapeutic use; D011433:Propranolol / Q000627:therapeutic use; D013117:Spinal Cord Compression / Q000209:etiology / Q000601:surgery*; D020246:Venous Thrombosis / Q000188:drug therapy / Q000209:etiology
chemical_list: D000319:Adrenergic beta-Antagonists; D000893:Anti-Inflammatory Agents; D000925:Anticoagulants; D006493:Heparin; D011239:Prednisolone; D011433:Propranolol
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