Delayed Massive Expansion of Subgaleal Hematoma Complicated with Proptosis in Hemophilia B

Abstract

Proptosis after a subgaleal hematoma (SGH) is a rare condition that may require immediate intervention to prevent visual loss. A 12-year-old boy presented with localized SGH in the left parietal area after hair-pulling. The SGH was massively expanded on the entire scalp on the 3rd day of the trauma. On the next day after the massive expansion, proptosis of the right eye occurred suddenly. Emergent needle aspiration of the SGH was performed, and the proptosis improved slightly. Fortunately, his vision did not deteriorate. After all, he was diagnosed with coagulation factor IX deficiency (hemophilia B). The supraorbital notch could be a passage of the SGH to extend into the subperiosteal space of the orbit.

A Rare Case of a Subgaleal Hematoma With Global Developmental Delay, Scurvy, and Congenital Toxoplasmosis, Rubella, Cytomegalovirus, Herpes Simplex, and HIV (TORCH) Infection

“…Subgaleal hematomas, though infrequently encountered, can occur following traumatic events, such as seizures. These hematomas are characterized by the accumulation of blood between the periosteum and the galea aponeurotica, often requiring prompt diagnosis and intervention to prevent complications [ 5 ]. The coexistence of GDD, congenital TORCH infection, scurvy, seizures, and subgaleal hematoma in a pediatric patient poses a diagnostic challenge.…”