title: Surgical management of large scalp infantile hemangiomas.
abstract: BACKGROUND
  Infantile Hemangiomas (IH) are the most common benign tumor of infancy, occurring in over 10% of newborns. While most IHs involute and never require intervention, some scalp IHs may cause severe cosmetic deformity and threaten tissue integrity that requires surgical excision.
  
  
  METHODS
  We present our experience with two infants who presented with large scalp IH. After vascular imaging, the patients underwent surgical resection of the IH and primary wound closure with excellent cosmetic outcome. We detail the surgical management of these cases and review the relevant literature.
  
  
  CONCLUSIONS
  In some cases the IHs leave behind fibro-fatty residuum causing contour deformity. Surgery is often required for very large lesions causing extensive anatomical and/or functional disruption. The goal of surgical intervention is to restore normal anatomic contour and shape while minimizing the size of the permanent scar.
authors.affiliation: Division of Neurosurgery, Geisel School of Medicine at Dartmouth, Lebanon NH, USA.
authors.forename: Imad S
authors.initials: IS
authors.lastname: Khan
authors.affiliation: Department of Neurosurgery, Hospital for Sick Children, Toronto, Canada.
authors.forename: Erin N
authors.initials: EN
authors.lastname: Kiehna
authors.affiliation: Department of Pediatrics, Geisel School of Medicine at Dartmouth, Lebanon NH, USA.
authors.forename: Komal F
authors.initials: KF
authors.lastname: Satti
authors.affiliation: Department of Neurosurgery, Vanderbilt University Medical Center, Nashville TN, USA.
authors.forename: Moneeb
authors.initials: M
authors.lastname: Ehtesham
authors.affiliation: Department of Neurosurgery, Vanderbilt University Medical Center, Nashville TN, USA.
authors.forename: Mahan
authors.initials: M
authors.lastname: Ghiassi
authors.affiliation: Division of Neurosurgery, Geisel School of Medicine at Dartmouth, Lebanon NH, USA.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Singer
keywords: Congenital abnormality; hemangioma; scalp; surgical management