Computed tomography findings of ongoing subgaleal hemorrhage

Abstract

Neonatal subgaleal hemorrhage (SGH) is a serious adverse event that is often underestimated and sometimes goes unrecognized. It can cause bleeding complications and jeopardize the patient's life. Early diagnosis and prompt treatment are important in optimizing the outcome in neonates with SGH. Herein we describe the case of a newborn who developed severe SGH and died. We report unenhanced computed tomography (CT) of ongoing SGH, which showed a low-density region in the surrounding area of the head. The density could be explained by unclotted active bleeding and low hematocrit. Even if a patient with clinically suspected SGH has a low-density region on CT, the presence of SGH should not be excluded.

Massive subgaleal hematoma in a 62-year-old man treated with apixaban as a consequence of mild head trauma

“…Secondly, after blunt head trauma, these veins can bleed and/or cause subgaleal hematoma. 1,2,[4][5][6][7] Subgaleal hematoma refers to hemorrhage in the space between the galea aponeurotica and the periosteum. There are normal anatomic boundaries that limit the spread of pathological processes, such as infections or hematomas, from the scalp to the neck.…”

“…15 In some cases, more invasive procedures, such as aspiration or drainage, are needed, especially for large and complicated subgaleal hematomas, in order to minimize the period of blood resorption, risk of infection, calcification and reaccumulation. 2,3…”

“…Subgaleal hematoma is a life-threatening condition characterized by the accumulation of blood in the space between the pericranium and the galea aponeurotica of the skull by the rupture of the emissary veins, connecting the extracranial venous system with the intracranial venous sinuses. [1][2][3] In the vast majority of cases, it is observed in newborns more frequently as a catastrophic complication of instrumental delivery. On the contrary, it is an extremely rare entity in the adult population and usually associated with severe head trauma and skull base fractures, coagulation disorders and traumatic or abusive hair pulling.…”

A Rare Cause of Subgaleal Hematoma in Children: Hair Pulling

“…4,6,14 Although it is a clinical diagnosis, CT is useful for patients with suspicion of abuse or traumatic brain injury. 7,15 Besides this, SGH can be the first manifestation of underlying coagulopathy such as von Willebrand disease and factor XIII deficiency. 3,6,13 Therefore, physicians must be careful about history of easy bleeding or bruising and medications like salicylate.…”