Magnetic resonance imaging revealed a 3.8 x 3 x 3.6 cm mass involving the posterolateral part of the clivus extending inferiorly to include the jugular tubercle and posterolateral aspect of the occipital condyle. MRA showed a medial displaced left carotid artery as well as a significant compression of the sigmoid sinus at the level of the jugular bulb and an anteriorly displaced internal jugular vein. Historic evaluation revealed preeclampsia with all three of the patient's previous pregnancies and reports of similar symptoms but to a lesser extent. Because the patient's symptoms were greater during and with each successive pregnancy, the endocrine and physiologic modifications of pregnancy may have augmented tumor growth and symptoms. Wilford Hall USAF Medical Center, Lackland AFB, Tex.
Vascular anomalies are among the most common congenital lesions of the head and neck.
While there have been many proposed classification of these lesions, the most commonly accepted system divides these lesions into vascular neoplasms, such as hemangioma and vascular malformations. Recommended treatment modalities have included observation, local excision, embolization, sclerotherapy, cryosurgery, radiotherapy, medical therapy with agents such as interferon and steroids, and laser photocoagulation. In addition, we provide a review of pertinent literature on treatment of such lesions. Brooke Army Medical Center, Fort Sam Houston, Tex. Few data are available on the effects of industrial respirators on sleep.