Subgaleal hematoma
Updates to Article Attributes
Subgaleal haematoma describes scalp bleeding in the potential space between the periosteum and the galea aponeurosis. It is a rare but possibly lethal emergency.
Epidemiology
ItModerate to severe presentations occur in 1.5 of 10 000 live births. It most commonly occurs after vacuum-assisted and forceps delivery, but may also be seen following head trauma or occur spontaneously. In patients with intracranial haemorrhage or skull fractures, the incidence of subgaleal haemorrhage is increased.
Clinical presentation
Signs include pallor on inspection. On examination, there may be tachycardia, hypotonia. A fluctuant scalp mass with increasing head circumference may be seen on palpation.
Pathology
Aetiology
Bleeding occurs as a result of rupture to emissary veins which drain the scalp veins into the dural sinuses.
Location
Due to being superficial to the periosteum, subgaleal haematomas are able to cross suture lines and canvas the entire skull.
Radiographic features
Ultrasound
- blood of moderate echogenicity
- decreasing echogenicity with time
- not bound by periosteum
CT
- more objective measurement of haematoma volume
- determine presence of an underlying skull fracture
Radiology report
- size of the haematoma
- content of the fluid collection
- presence of an associated fracture
Differential diagnosis
General imaging differential considerations include:
-
scalp haematoma
- caput succedaneum
- subgaleal haematoma
- cephalohaematoma
- subgaleal abscess
On certain MRI sequences also consider:
See also
-<p><strong>Subgaleal haematoma</strong> describes <a href="/articles/scalp-1">scalp</a> bleeding in the potential space between the periosteum and the <a href="/articles/galea-aponeurotica">galea aponeurosis</a>.</p><p>It most commonly occurs after vacuum-assisted delivery, but may also be seen following head trauma. In patients with intracranial haemorrhage or skull fractures, the incidence of subgaleal haemorrhage is increased.</p><h4>Differential diagnosis</h4><p>General imaging differential considerations include:</p><ul>- +<p><strong>Subgaleal haematoma</strong> describes <a href="/articles/scalp-1">scalp</a> bleeding in the potential space between the periosteum and the <a href="/articles/galea-aponeurotica">galea aponeurosis</a>. It is a rare but possibly lethal emergency.</p><h4>Epidemiology</h4><p>Moderate to severe presentations occur in 1.5 of 10 000 live births. It most commonly occurs after vacuum-assisted and forceps delivery, but may also be seen following head trauma or occur spontaneously. In patients with intracranial haemorrhage or skull fractures, the incidence of subgaleal haemorrhage is increased.</p><h4>Clinical presentation</h4><p>Signs include pallor on inspection. On examination, there may be tachycardia, hypotonia. A fluctuant scalp mass with increasing head circumference may be seen on palpation.</p><h4>Pathology</h4><h5>Aetiology</h5><p>Bleeding occurs as a result of rupture to emissary veins which drain the scalp veins into the dural sinuses.</p><h5>Location</h5><p>Due to being superficial to the periosteum, subgaleal haematomas are able to cross suture lines and canvas the entire skull.</p><h4>Radiographic features</h4><h5>Ultrasound</h5><ul>
- +<li>blood of moderate echogenicity</li>
- +<li>decreasing echogenicity with time</li>
- +<li>not bound by periosteum</li>
- +</ul><h5>CT</h5><ul>
- +<li>more objective measurement of haematoma volume</li>
- +<li>determine presence of an underlying skull fracture</li>
- +</ul><h4>Radiology report</h4><ul>
- +<li>size of the haematoma</li>
- +<li>content of the fluid collection</li>
- +<li>presence of an associated fracture</li>
- +</ul><h4>Differential diagnosis</h4><p>General imaging differential considerations include:</p><ul>
References changed:
- 3. Bansal AG, Oudsema R, Masseaux JA, Rosenberg HK. US of Pediatric Superficial Masses of the Head and Neck. (2018) Radiographics : a review publication of the Radiological Society of North America, Inc. 38 (4): 1239-1263. <a href="https://doi.org/10.1148/rg.2018170165">doi:10.1148/rg.2018170165</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/29995618">Pubmed</a> <span class="ref_v4"></span>
Tags changed:
- rg_38_4_edit
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