Massive traumatic subgaleal haematoma

Kichari, Jayant R.; Gielkens, H. A. J.

doi:10.1136/emermed-2012-201729

Cited by 13 publications

(7 citation statements)

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“…However, aspiration or surgery may be mandatory in case of failure of conservative treatment. [1] Head trauma involving application of tangential or radial forces to the scalp causing rupture of emissary veins traversing the subgaleal space can lead to the formation of subgaleal hematoma. [10] Following trivial trauma, some emissary vein might have ruptured which would have continued to bleed internally due to the presence of an underlying coagulation disorder (hypofibrinogenemia) leading to the formation of massive subgaleal hematoma in our patient.…”

Section: Discussionmentioning

confidence: 99%

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Massive hemopericranium following trivial trauma in a child with hypofibrinogenemia: A case report and review of the literature

Gupta

Rajkumar²

2017

IJNS

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166minor injuries in the past was present, but there was no externally visible bleeding this time. There was no history suggesting a familial bleeding disorder. Clinically, child was active and alert without any neurological deficit. Head circumference was 62 cm, with fluctuant nontender circumferential scalp swelling [ Figure 1a] with areas of crust formation (due to pressure necrosis) without any discharge. Question mark scar of the previous craniotomy on the left side of the head was present. There were no features of raised intracranial pressure, meningitis, or scalp infection. Computed tomography (CT) head [ Figure 2] showed a left parieto-occipital extradural hematoma and massive circumferential extracalvarial hypodense scalp collection [ Figure 2a] which was increasing on repeat scan [ Figure 2b]. There was no brain parenchymal hematoma or skull fracture. Hemogram, peripheral smear, liver and renal function tests, and abdominal ultrasound were normal. Blood group was O positive. Both prothrombin time (PT) and activated partial thromboplastin time (aPTT) were deranged, but thrombin time was normal. Serum fibrinogen level was low -156 mg/dL (normal 200-400 mg/dL). Factors V and VIII assays were normal. D-dimer assay was normal. Patient was managed by fresh frozen plasma (FFP) transfusion till correction of PT and aPTT followed by needle aspiration of scalp collection -1300 ml of altered liquefied blood was aspirated (in three stages) and circumferential pressure head bandage was applied. Head circumference reduced to 48 cm [ Figure 1b]. He is asymptomatic at 6 months follow-up and is advised to take precautions to avoid all sorts of injuries like contact sports.

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Section: Discussionmentioning

confidence: 99%

“…They generally have low volume and often resolve spontaneously. [1] Occasionally, they can achieve a large volume and may endanger the patient's life especially in neonates. Intracerebral hematoma does not correlate with the severity of subgaleal hematoma.…”

Section: Introductionmentioning

confidence: 99%

Massive hemopericranium following trivial trauma in a child with hypofibrinogenemia: A case report and review of the literature

Gupta

Rajkumar²

2017

IJNS

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“…SGH has been reported as a result of head trauma in older children and was previously thought to be a sign of abuse . SGH is seen in abusive blunt head trauma and abusive hair pulling but is not diagnostic of abuse.…”

Section: Literature Reviewmentioning

confidence: 99%

Subgaleal haematoma due to hair pulling: Review of the literature

2019

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Subgaleal haematoma (SGH) is a collection of blood in the potential space covered by the galea aponeurotica from the orbital ridges anteriorly to the nuchal ridge of the neck posteriorly ( Figure 1). Subgaleal haematoma is most commonly found in the setting of birth trauma as well as in blunt head trauma, but has rarely been described as consequence of non-abusive pulling of the hair. We review the literature for all cases of SGH as a result of non-abusive hair straightening or pulling without evidence of coagulopathy. Our literature review describes the pattern of SGH as a result of hair pulling, and we discuss the potential complications of this entity. | LITER ATURE RE VIE WSubgaleal haematoma is most commonly found in the setting of birth trauma and can be fatal in neonates. 1 In older children, SGH Abstract Aim: To identify all cases of subgaleal haematoma (SGH) as a result of non-abusive hair straightening or pulling without evidence of blunt trauma or coagulopathy. Methods:We conducted a search in the English-language literature of all cases of SGH in children. We excluded those in neonates, those in which the child was abused by a caregiver, those in which blunt trauma was not excluded, and those in which a coagulopathy or other blood dyscrasia was found.Results: Sixteen cases were identified in children from a range of ages. Time to presentation ranged from several days to a week and a half. In most cases, management is conservative, though SGH can cause fever, symptomatic anaemia and can threaten vision. Conclusion:Subgaleal haematoma can occur in otherwise healthy children, can accumulate slowly and can result in sequelae. However, most cases of SGH are managed conservatively.

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“…In older children-as in index patient-it may be seen after minor head trauma or may be of nontraumatic origin. The hematoma often resolves spontaneously or with conservative treatment using a compression bandage (usually within a few weeks) [3]. In case of failure of conservative treatment, aspiration or surgery may be mandatory [1][2][3].…”

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confidence: 99%