Wang Yong, Zhang Jiliang
From the *Departments of Neurosurgery, and †Radiology, Henan Provincial People's Hospital, Zhengzhou, China.
J Craniofac Surg. 2013 Sep;24(5):1603-5. doi: 10.1097/SCS.0b013e3182a20ffb.
Subperiosteal hematoma is the accumulation of blood between the periosteum and the skull, which commonly occurs in the neonatal period but rarely in other ages. Subperiosteal hematoma can be self-absorbed in most cases and occasionally may cause ossification.
This study reports a case of subperiosteal hematoma formed in a 16-year-old adolescent boy after a minor trauma. Because the hematoma did not disappear for more than a month after the trauma, the patient was treated with multiple hematoma punctures. However, the hematoma recurred and led to ossification. Finally, the patient underwent surgical treatment.
Finally, the ossification associated with the hematoma was treated through surgery. The head contour recovered normally.
The occurrence of hematoma ossification in the 16-year-old patient suggests that the periosteum has great potential for osteogenesis. This is likely caused by the joint action of some active factors in the blood and a certain tension of the hematoma on the local periosteum. This case provides the following thoughts. (1) A subperiosteal hematoma that has not been absorbed after 1 month should be treated promptly to avoid ossification. Once ossification has occurred, the hematoma should be treated surgically. (2) The potential for periosteal osteogenesis is great, which may provide a new thought for cranioplasty.
骨膜下血肿是指血液在骨膜与颅骨之间积聚，常见于新生儿期，在其他年龄段则较为罕见。大多数情况下，骨膜下血肿可自行吸收，偶尔可能会导致骨化。
本研究报告了1例16岁青少年男性在轻微外伤后形成骨膜下血肿的病例。由于外伤后血肿1个多月未消失，该患者接受了多次血肿穿刺治疗。然而，血肿复发并导致骨化。最终，患者接受了手术治疗。
最终，与血肿相关的骨化通过手术得到治疗。头部外形恢复正常。
该16岁患者出现血肿骨化提示骨膜具有巨大的成骨潜力。这可能是由血液中某些活性因子与血肿对局部骨膜的一定张力共同作用所致。该病例提供了以下思路。（1）骨膜下血肿1个月后未吸收应及时治疗，以避免骨化。一旦发生骨化，应手术治疗血肿。（2）骨膜的成骨潜力巨大，这可能为颅骨成形术提供新的思路。
