Subgaleal Hematoma at the Contralateral Side of Scalp Trauma in an Adult
| Autor: | Yi-Rong Chen, Yen-Heng Lee, Cheng-Chieh Liu, Ching-En Chen, Zen-Zhon Liao, Chi-Kao Tang |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Rotation medicine.medical_treatment Hemorrhage Emissary veins Lacerations Head trauma 03 medical and health sciences 0302 clinical medicine Hematoma 030225 pediatrics Incision and drainage medicine Craniocerebral Trauma Humans Aponeurosis Scalp business.industry medicine.disease Temporal Lobe Surgery medicine.anatomical_structure Emergency Medicine Forehead Emergency Service Hospital Tomography X-Ray Computed business 030217 neurology & neurosurgery Bandage |
| Zdroj: | The Journal of Emergency Medicine. 53:e85-e88 |
| ISSN: | 0736-4679 |
| DOI: | 10.1016/j.jemermed.2017.06.007 |
| Popis: | Background Subgaleal hematoma (SGH), an abnormal accumulation of blood under the galeal aponeurosis of the scalp, is more commonly observed in newborns and children. According to previous cases, the etiology of SGH includes mild head trauma, vacuum-assisted vaginal delivery, contusion, and hair braiding or pulling. Case Report A 39-year-old healthy worker came to our emergency department (ED) due to scalp lacerations from an accident that caused severe twisting of his hair. He denied head contusion and was conscious upon arrival. Physical examination showed three lacerations over his right temporal area. The wounds depth extended to the skull, with a 10-cm subperiosteal pocket beneath the lacerations. Primary sutures were performed immediately under local anesthesia, not only for wound closure but also for hemostasis. However, he returned to our ED 3 h after the first visit for a newly developed soft lump over the left side of his forehead. Computed tomography scan of brain illustrated a huge and diffuse SGH in the left temporal region with extension to periorbital region. Although the option of incision and drainage was discussed with a neurosurgeon and a search for some case reports was done, most of the hematoma could be self-limited. Conservative management with non-elastic bandage packing direct compression was applied. The patient was then admitted for close observation and conservative treatment for 1 week. There was no recurrence of SGH in the following 3 months. Why Should an Emergency Physician Be Aware of This? SGH is an uncommon phenomenon that is caused by tearing of the emissary veins in the loose areolar tissue located beneath the galeal aponeurosis. Conservative treatment with bandage compression is recommended for SGH. Surgery is reserved for cases where non-invasive management fails or severe complications. |
| Databáze: | OpenAIRE |
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