Massive, Spontaneous Facial Hematoma in a Neurofibromatosis Type 1 Patient

Significant hemorrhage in Neurofibromatosis Type 1 (NF-1) patients occurs infrequently, but has potentially devastateing consequences when occurring in the head and neck region. There have been no prior reports of patients with hemodynamically significant, rapidly-expanding lesions into a neurofibroma in the head and neck region without preceding trauma. This case describes the management of a spontaneous, rapidly expanding facial hematoma in an NF-1 patient with an extensive facial and skull base plexiform neurofibroma. The patient underwent angioembolization of his left external carotid artery prior to operative management. The strategies utilized can be extended to management of facial hematomas arising from more common situations such as fractures, lacerations, and pseudoaneursyms, along with bleeding from subacute conditions like other head and neck cancers.