Haemangiomas

Definition

• haemangiomas are benign lesions characterized by vascular spaces lined with endothelial cells, 50% in spine, 20% in skull

Presentation

• 40-50 peak incidence
• usually asymptomatic (incidental finding)
• neurological symptoms or back pain

Investigations

• Xray
  • vertebra
    • thickened vertical trabeculae secondary to erosion of horizontal trabeculae
  • skull
    • radiating wheel spoke
• CT
  • polka dot appearance
• MRI
  • T1 low, T2 high
• Bone scan
  • repeat local staging at hot spots
• Biopsy

Treatment

NonOperative

• If asymptomatic – observe
• Radiation
  • spine
• Embolization
  • either as Treatment or preop

Operative

• Excision & bone graft
  • always preop embolization