Late Vascular Complication Associated With Panfacial Fractures

embers suggests a sporadic mutation affecting one f the genes responsible for bone homeostasis in this atient. Cranial nerve compression has been described in atients’ with van Buchem disease; however, cerebroascular accidents have not been identified comonly in these patients. Although the patient decribed some disturbance in facial sensation and isplayed skull bone thickening radiographically, it is ifficult to say whether the condition contributed to he cerebrovascular accidents without radiologic evience of compression of the brain or vascular canals n the skull base. Previous reports of surgical intervention on paients with van Buchem disease and ADO have ndicated normal healing although no comments have een made on longer term recurrence at surgicallyddressed sites. We were concerned about the healng capacity of the bone and carried out more limited urgery at the first intervention. These fears seem to e unfounded and, ironically with the wisdom of indsight, the history of palmidronate infusions hould have caused greater concern.