A marked exophthalmos and corneal ulceration caused by delayed massive expansion of a subgaleal hematoma
A marked exophthalmos and corneal ulceration caused by delayed massive expansion of a subgaleal hematoma
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DOI：
10.1007/s00381-004-1054-8
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发表时间：
2005-06-01
影响因子：
1.4
通讯作者：
Suzuki, M
中科院分区：
文献类型：
--
作者：
Fujisawa, H;Yonaha, H;Suzuki, M
病例报告：一位12岁的女孩在一次争吵中被拉扯了右侧头发，之后在她的右侧颅骨上形成了一个帽状腱膜下血肿。皮下肿胀进展到前额，然后在左侧出现明显的眼球突出。手术切除了双侧液化的SGH，并引入了两个连接到真空引流泵的引流导管。手术后，SGH消失。通过穿刺左眼眶的上外侧部分抽吸液化的血肿。此后，左侧眼球突出迅速消失。SGH的化学分析显示，它含有极低水平的纤维蛋白原和血小板，以及高水平的纤维蛋白原和纤维蛋白降解产物，表明继发性纤维蛋白溶解已发生在帽状腱膜下空间。讨论和结论：帽状腱膜下血肿通常采用保守治疗。但是，有必要进行封闭观察，如果发现扩张增加，应考虑使用封闭引流系统进行抽吸。
Case report: A 12-year-old girl had the hair on the right side of her head pulled during a quarrel, after which a subgaleal hematoma (SGH) developed over her right cranium. The subcutaneous swelling progressed to the forehead, and a marked exophthalmos then developed on the left side. The bilateral, liquefied SGH was removed surgically, and two drainage catheters connected to a vacuum-drain pump were introduced. After the surgery, the SGH disappeared. The liquefied hematoma was aspirated by puncturing the superolateral portion of the left orbit. Thereafter, the left exophthalmos rapidly disappeared. A chemical analysis of the SGH revealed that it contained extremely low levels of fibrinogen and platelets, and high levels of fibrinogen and fibrin degradation products, suggesting that secondary fibrinolysis had occurred in the subgaleal space. Discussion and conclusion: Subgaleal hematomas are usually treated conservatively. However, closed observation is necessary, and if increased expansion is seen, aspiration with a closed drainage system should be considered.