Calvarial and phalangeal vascular impressions in thalassemia

The nutrient foramina in the phalanges and/or the calvarial vascular markings were evaluated in 34 patients with thalassemia. Enlarged nutrient foramina were noted in 17 patients, and abnormal calvarial markings were observed in 19 patients. The prominence of the vascular changes in the phalanges paralleled those in the calvaria, and the calvarial vascular impressions correlated with the width of the skull. The enlarged superficial calvarial vessels associated with the vascular impressions may represent a hazard to the patient. A transfusion regimen from an early age seemed to prevent enlargement of these vascular impressions.