Bilateral Otorrhagia and Orbital Hematoma Complicating Subgaleal Hematoma

Okafor, B. C.

doi:10.1177/000348948409300310

Cited by 14 publications

(10 citation statements)

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“…4 -6 Reports of orbital extension are scarce and usually related to blunt head trauma. 4 We report a case of subgaleal hematoma with orbital extension that resulted from the relatively minor trauma of hair pulling.…”

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confidence: 99%

Proptosis After Hair Pulling

Yip¹,

McCulley²,

Kersten³

et al. 2003

Ophthalmic Plastic & Reconstructive Surgery

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We describe proptosis due to a subperiosteal orbital hematoma that originated from a subgaleal bleed caused by hair pulling. A 13-year-old boy presented with a one-week history of progressive proptosis after his older sister pulled his hair during an argument. Computerized tomography showed a subgaleal hematoma and a right superior subperiosteal orbital hematoma. Progressive proptosis and compressive optic neuropathy developed, necessitating surgical evacuation with a favorable outcome.Hair pulling can result in a subgaleal bleed with extension to the orbital subperiosteal space. When managing patients with a subgaleal hematoma, this vision-threatening complication should be considered and treated accordingly.

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confidence: 99%

Proptosis After Hair Pulling

Yip¹,

McCulley²,

Kersten³

et al. 2003

Ophthalmic Plastic & Reconstructive Surgery

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“…These patients may exhibit irritability, lethargy, hypotonia and seizures [13,19] . Rarely reported complications of SGH include otorrhagia, retro-orbital hematoma, and jaundice from breakdown of hemoglobin [20,21] . Subgaleal abscesses are well described in the literature, with the most common causes being fetal scalp monitoring, mistreated scalp lacerations, postoperative infection, and needle aspiration of an SGH [6,22] .…”

Section: Discussionmentioning

confidence: 99%

Infected Subgaleal Hematoma Following Blunt Head Trauma in a Child: Case Report and Review of the Literature

et al. 2015

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Subgaleal hematoma (SGH), an uncommon but potentially dangerous complication, has been reported to occur with delivery in newborns, as well as in young patients following head trauma. Infection of a SGH is extremely rare, especially in cases where no disruption of the skin barrier occurs. We report a case of an infected SGH in an 8-month-old following closed skull fracture. The patient presented with scalp swelling 1 day after falling 3 feet. Initial evaluation found a nondisplaced skull fracture on computed tomography. She was discharged following an uneventful 23-hour observation. Three days later, she developed symptoms concerning for a viral upper respiratory tract infection and received symptomatic treatment. Nine days after injury, she returned with continued fevers, irritability, and significant increase in scalp swelling. Magnetic resonance imaging showed a subgaleal abscess with osteomyelitis. Needle aspiration revealed an infected hematoma with cultures positive for Streptococcus pneumoniae, treated with intravenous ampicillin. Purulent drainage from an enlarging necrotic needle aspiration site required subsequent surgical debridement of the subgaleal abscess with drain placement. She recovered well following surgery and intravenous antibiotics. Physicians should be aware that SGH carries a risk of serious morbidity and mortality. SGH can serve as a nidus for infection, typically from skin barrier breakdown or, as in this case, hematogenous spread. Early recognition, appropriate antibiotic therapy, and surgical debridement are critical in treating infected SGH.

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“…All 11 had surgery. Six patients returned to 20/20 vision after surgery; 1 improved to 20/30, 12 1 remained no light perception, 5 1 was lost to follow-up, 13 and for 2 it was only indicated that "orbital swelling resolved" without a note of visual acuity. 10,14 Six reported cases had bleeding disorders: 15 (Factor IX deficiency [Christmas disease] 16 and heterozygous Factor VII deficiency).…”

Section: Discussionmentioning

confidence: 99%

“…17 No bleeding anomaly was found in our patient. Other reported associations include sickle cell disease, vitamin C deficiency, 6 hypertension, 13 and thrombocytopenia secondary to congenital heart disease. 18 Child abuse should be considered when evaluating SGH.…”

Section: Discussionmentioning

confidence: 99%

“…Hair pulling ( by other children while playing) 6,9,11 3 Hair pulling (child abuse by mother's boyfriend) 1 1 Hair braiding 17 1 "Minor" head trauma 14 1 Fall from bike 5 1 Assault (karate chop to head) 13 1 Struck head at home while playing* 4 2 Struck head on playground pole 16 1 Fall while roller skating 7 1 Struck by falling frying pan 10 1 Punch to parietal region by sibling 12 1 *our patient.…”

Section: Literature Searchmentioning

confidence: 99%

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