Purpose: To present a case of a child with an extensive facial hemangioma in whom the suspicion of intracranial involvement was raised by visual evoked potential (VEP) evaluation.
Design: Observational case report.
Methods: VEP analysis was performed using flash and pattern stimuli to determine whether treatment intervention other than occlusion therapy was needed.
Results: VEP analysis indicated a marked transoccipital asymmetry in the flash and pattern VEP suggestive of right hemispheric dysfunction. Neuroimaging showed intracranial extension of the hemangioma.
Conclusion: The VEP evaluation is a noninvasive technique performed in the awake child. This case highlights the usefulness of VEP analysis in the management of extensive periocular capillary hemangiomas and its use as a modality to identify potential intracranial involvement. Large plaquelike facial capillary hemangiomas may have possible underlying dural involvement suggestive of PHACES syndrome.