The differentiation of haemangiomas and vascular
malformations is histological, clinical and prognostic.
Although the majority of haemangiomas evolve towards
spontaneous resolution, as many as 10% of cases can
develop complications with ulceration, pain and haemorrhaging.
Besides, the localisation of haemangiomas in
the head and neck, next to vital structures, can compromise
their functions. Hence, compression of the airway
might be a vital emergency. Periorbital haemangiomas
can give rise to amblyopia due to sensory deprivation or
due to a restrictive strabismus. Lumbosacral haemangiomas
must be studied with Nuclear Magnetic Resonance
because of their frequent association with alterations
in the midline at the level of the spine, anus, genitals
or kidneys. Amongst visceral haemangiomas,
hepatic haemangiomas are the most serious due to their
association with congestive cardiac insufficiency. The
association of extensive facial haemangiomas with
anomalies of the central nervous system, vascular, cardiac,
ocular and sternal anomalies, is denominated
PHACE syndrome and is frequently complicated by mental
deficiency, convulsions or ictus.
Vascular malformations of trigeminal localisation
are associated in up to 15% of cases with glaucoma or
choroidal or leptomeningeal haemangiomas (Sturge-
Weber syndrome). Combined vascular malformations
localised in the extremities can become complicated
with thrombophlebitis, regional osteolysis and even
distant thromboembolisms (Klippel-Treneaunay Syndrome).
On the other hand, there is a coagulopathy
due to consumption (Kassabach-Merrit Syndrome)
that can complicate some vascular tumours such as
the Kaposiform haemangioendothelioma and the tufted
angioma. Finally, the complications of the treatments
employed are reviewed
