Fujisawa Hirosuke, Yonaha Hiroyasu, Oka Yoichiro, Uehara Masato, Nagata Yoshihiko, Kajiwara Koji, Fujii Masami, Kato Shoichi, Akimura Tatsuo, Suzuki Michiyasu
Department of Neurosurgery, Clinical Neuroscience, Yamaguchi University School of Medicine, 1-1-1 Minami-kogushi, Ube, Yamaguchi 755-8505, Japan.
Childs Nerv Syst. 2005 Jun;21(6):489-92. doi: 10.1007/s00381-004-1054-8. Epub 2004 Dec 14.
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.
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.
一名12岁女孩在争吵中右侧头部头发被拉扯，之后其右颅骨上方出现帽状腱膜下血肿（SGH）。皮下肿胀蔓延至前额，随后左侧出现明显眼球突出。通过手术切除双侧液化的SGH，并插入两根连接真空引流泵的引流导管。术后，SGH消失。通过穿刺左眼眶的外上部分吸出液化血肿。此后，左侧眼球突出迅速消失。对SGH的化学分析显示，其纤维蛋白原和血小板水平极低，而纤维蛋白原和纤维蛋白降解产物水平较高，提示帽状腱膜下间隙发生了继发性纤维蛋白溶解。
帽状腱膜下血肿通常采用保守治疗。然而，必须进行密切观察，若发现血肿扩大，则应考虑采用闭式引流系统进行抽吸。
