MASSIVE INTRATUMOR HEMORRHAGE IN FACIAL PLEXIFORM NEUROFIBROMA

Background. Plexiform neurofibromatosis is a feature of von Recklingha usen's disease. Head and neck lesions may produce varying degrees of c osmetic and functional deformity. However, life-threatening hemorrhage into facial plexiform neurofibromas has not been previously reported. Method: We report two patients with von Recklinghausen's disease who experienced massive hemorrhage into facial neurofibromas, one followin g a blunt injury and the other without a known initiating event. Resul ts: Conservative management did not stop the hemorrhage into facial ne urofibromas in either instance. Surgical exploration was mandated for hemorrhage control and evacuation of blood clots. Hemostasis was attai ned by a combination of hypotensive anesthesia and chromic catgut sutu re ligatures. Conclusions: These case reports demonstrate a potentiall y lethal complication in patients with facial plexiform neurofibroma. Where a competent and experienced interventional neuroradiologist is n ot available, surgical exploration should be undertaken to control ble eding. (C) 1997 John Wiley & Sons, Inc.