Subgaleal Hematoma at the Contralateral Side of Scalp Trauma in an Adult

Chen, Ching-En; Liao, Zen-Zhon; Lee, Yen-Heng; Liu, Cheng-Chieh; Tang, Chi-Kao; Chen, Yirong

doi:10.1016/j.jemermed.2017.06.007

Cited by 14 publications

(15 citation statements)

References 10 publications

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“…Although an extra-axial hemorrhage in SCD is very rare [ 5 ], reports of all types of extra- or intra-axial hemorrhages or combinations of them have been shown to be associated with SCD [ 6 ]. In adults, an SGH is usually caused by trauma and involves blood accumulation between the epicranial aponeurosis or galea aponeurotica and the periosteum because of rupture of the emissary veins [ 7 ]. SGH has been reported in SCD patients presenting with SGH in combination with spontaneous EDH [ 1 , 2 , 5 , 8 , 9 ].…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Subgaleal Hematoma in a Sickle Cell Disease Patient: A Case Report

2020

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Sickle cell disease (SCD) is one of the most commonly inherited conditions on the Arabian Peninsula. We report a case of a 17-yearold boy, who had previously been diagnosed with SCD and glucose-6-phosphate dehydrogenase (G6PD) deficiency and recently presented to our hospital with spontaneous subgaleal hematoma (SGH), which was managed conservatively. We also present a literature review on the topic of spontaneous intra-and/or extra-cranial bleeds.

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Section: Discussionmentioning

confidence: 99%

Spontaneous Subgaleal Hematoma in a Sickle Cell Disease Patient: A Case Report

2020

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“…[ 1 ] The previous reports in the literature have cited spontaneous SGH with workup uncovering blood dyscrasias, including impaired platelet aggregation,[ 14 ] Vitamin K deficiency,[ 30 ] or deficient/nonfunctional coagulation factors. [ 4 , 12 , 29 ] Accordingly, a comprehensive hematological workup should ensue when presented with a pediatric patient with a diagnosis of SGH, especially without compression has also been advocated,[ 3 ] as a prelude to surgical intervention. Ultimately, conservative treatment is preferential due to the risk of infection which can spread through the emissary veins to the dural sinuses secondary to more invasive interventions.…”

Section: Discussionmentioning

confidence: 99%

Subgaleal hematoma evacuation in a pediatric patient: A case report and review of the literature

Patchana

Ghanchi

Taka

et al. 2020

Surgical Neurology International

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Background: Subgaleal hematoma (SGH) is generally documented within the neonatal period and is rarely reported as a result of trauma or hair braiding in children. While rare, complications of SGH can result in ophthalmoplegia, proptosis, visual deficit, and corneal ulceration secondary to hematoma extension into the orbit. Although conservative treatment is preferential, expanding SGH should be aspirated to reduce complications associated with further expansion. Case Description: A 12-year-old African-American female with no recent history of trauma presented with a chief complaint of headache along with a 2-day history of enlarging 2–3 cm ballotable bilateral frontal mass. Hematological workup was negative. The patient’s family confirmed a long history of hair braiding. The patient was initially prescribed a period of observation but returned 1-week later with enlarging SGH, necessitating surgical aspiration. Conclusion: SGH is rare past the neonatal period, but can be found in pediatric and adolescent patients secondary to trauma or hair pulling. Standard workup includes evaluation of the patient’s hematological profile for bleeding or coagulation deficits, as well as evaluation for child abuse. Although most cases of SGH resolve spontaneously over the course of several weeks, close follow-up is recommended. The authors present a case of a 12-year-old female presenting with enlarging subgaleal hemorrhages who underwent surgical aspiration and drainage without recurrence. A literature review was also conducted with 32 pediatric cases identified, 20 of which were related to hair pulling, combing, or braiding. We review the clinical course, imaging characteristics, surgical management, as well as a review of the literature involving subgaleal hemorrhage in pediatric patients and hair pulling.

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“…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.…”

Section: Introductionmentioning

confidence: 99%

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

Pagkou¹,

Papavramidis²,

Mavropoulou³

et al. 2021

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Subgaleal hematoma, accumulation of blood in the loose areolar tissue of the subgaleal space of the skull, is considered the most catastrophic complication of instrumental delivery. It is a rare finding in older ages, usually associated with coagulation disorders, severe head trauma leading to skull base fractures and accidental or abusive hair pulling. Complications include periorbital necrotising fasciitis, permanent blindness, infections and, in extreme rare cases, airway obstruction. Most cases of subgaleal hematoma resolve spontaneously, without the need of aspiration or drainage. We present here the case of a 62-year-old male on anticoagulant therapy with apixaban for chronic atrial fibrillation, who came to the emergency department after a car accident suffering from mild head trauma. The patient was complaining of a diffuse headache and physical examination showed a large ecchymosis and edema on the frontal area of the head. His neurological examination was unremarkable. Full-body computed tomography (CT) revealed a fracture of the third right rib. Twelve hours after admission, due to an excessive decrease of hematocrit, a second CT was performed. Although the images didn’t show intracranial hemorrhage or skull base fractures, a large and diffuse hematoma of the subaponeurotic space was observed and the diagnosis of subgaleal hematoma was confirmed. Massive subgaleal hematoma after mild head trauma is rather infrequent. Early diagnosis improves outcomes and can avert serious complications. Therapeutic strategy should be based on the severity of each case. In our case, conservative treatment appeared to be a valid alternative to surgery, as hematoma resolved spontaneously within 10 days. It is noteworthy that the use of anticoagulation is the only evident factor that could have been the precipitating factor for the development of the hematoma in our patient.

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Subgaleal Hematoma at the Contralateral Side of Scalp Trauma in an Adult

Cited by 14 publications

References 10 publications

Spontaneous Subgaleal Hematoma in a Sickle Cell Disease Patient: A Case Report

Spontaneous Subgaleal Hematoma in a Sickle Cell Disease Patient: A Case Report

Subgaleal hematoma evacuation in a pediatric patient: A case report and review of the literature

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

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