Calvarium Subperiosteal Hematoma in a 12-Year-Old Boy.
Calvarium Subperiosteal Hematoma in a 12-Year-Old Boy.
复制标题
DOI：
10.7759/cureus.16550
复制
发表时间：
2021-07
期刊：
影响因子：
--
通讯作者：
Akiyama K
中科院分区：
文献类型：
--
作者：
Yoneoka Y;Seki Y;Akiyama K
摘要颅骨骨膜下血肿在青少年是非常罕见的。我们提出了一个非常罕见的情况下，少年C-SPOH和文献回顾。一个12岁的男孩在一场足球比赛中把头重重地撞到了另一个球员的头上。比赛第二天（第02天），他注意到左顶骨区域有一个软肿块。第4天，患者就诊于当地医生，被诊断为帽状腱膜下血肿。血肿变大，达到第04天的两倍大小，在接下来的5天内变得更加疼痛。第10天的CT扫描显示皮下血肿未穿过缝合线。使用带18号针头的注射器抽吸，获得约45 mL液化血肿，导致肿块塌陷，疼痛缓解。然而，在第12天，他出现了与第10天相同的肿块和相似的疼痛。CT血管造影显示无血管异常或破裂。血液采样试验显示凝血功能正常，无血小板减少症或营养不良。第二次抽吸获得45 mL液化血肿。在第二次手术中，用生理盐水（约5 mL x 4）冲洗血肿腔。他服用氨甲环酸250 mg，每日三次，泼尼松龙5 mg，每日三次，共4天。第15天，他的C-SPOH不紧张，也不疼痛。第22天，骨膜血肿保持柔软和缩小。随访CT扫描显示第57天骨膜下血肿完全消失。这名男孩已经恢复了足球活动，没有后遗症。该病例提示：1）C-SPOH可在健康青少年中发现; 2）沿着C-SPOH腔壁的新生血管沿着可能有助于C-SPOH的形成; 3）简单抽吸液化的SPOH可能无法治愈青少年。
Calvarium subperiosteal hematoma (C-SPOH) is extremely rare in juveniles. We present an extremely rare case of juvenile C-SPOH and a review of the literature. A 12-year-old boy hit his head hard against another player’s head during a soccer game. On the next day of the game (Day 02), he noticed a soft bump on the left parietal region. On Day 04, he saw a local physician and was diagnosed with a subgaleal hematoma. The hematoma grew larger, up to twice the size of that on Day 04 and it became more painful over the next five days. A CT scan on Day 10 showed a subcutaneous hematoma that did not cross the suture lines. Aspiration using a syringe with an 18-gauge needle obtained about 45 mL liquefied hematoma and caused the bump collapse with relief of the pain. On Day 12, however, he presented the same bump with similar pains as on Day 10. CT angiography revealed no vascular anomalies or disruptions. A blood sampling test demonstrated normal blood coagulation ability without thrombocytopenia or malnutrition. A second aspiration obtained 45 mL liquefied hematoma. In the second procedure, the hematoma cavity was irrigated with normal saline solution (about 5 mL x 4). He took 250 mg tranexamic acid three times a day and 5 mg prednisolone three times a day for four days. On Day 15, his C-SPOH was not tense and not painful. On Day 22, the periosteal hematoma remained soft and shrunk. A follow-up CT scan showed the complete disappearance of the subperiosteal hematoma on Day 57. The boy has returned to soccer-playing activity without sequelae. This case suggests that 1) C-SPOH can be found in healthy juveniles; 2) Neovascularization along the wall of the C-SPOH cavity may contribute to the formation of the C-SPOH; 3) A simple aspiration of the liquefied SPOH may fail to cure it in juveniles.