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Subgaleal Hemorrhage
Subgaleal Hematoma

Presentation

Examination of the head, including the circumference of the head and assessment of the location and characteristics of any swelling (Table 1), should be repeated hourly if concerns are present. [ncbi.nlm.nih.gov]

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. [radiopaedia.org]

If your healthcare provider used a vacuum extractor to help deliver your baby, they’ll be closely monitored in the nursery even if they don’t present any immediate physical signs of a subgaleal hemorrhage because blood accumulation in the subgaleal area [my.clevelandclinic.org]

Entire Body System

  • Swelling

    Swelling on their head that has a liquid-like movement (boggy swelling) due to internal bleeding. [my.clevelandclinic.org]

    The presence of fluctuance early on, whether or not the swelling is progressive, is an important distinguishing feature of subgaleal hemorrhage. [ncbi.nlm.nih.gov]

  • Internal Bleeding

    Swelling on their head that has a liquid-like movement (boggy swelling) due to internal bleeding. [my.clevelandclinic.org]

Cardiovascular

  • Tachycardia

    On examination, there may be tachycardia and/or hypotonia. A fluctuant scalp mass with increasing head circumference may be seen on palpation. As the potential space extends into the neck, a subgaleal hematoma may also extend into the neck. [radiopaedia.org]

    Fast heart rate (tachycardia). Low blood pressure. Pale skin tone (pallor). Reduced levels of hemoglobin and hematocrit in their blood due to major blood loss. [my.clevelandclinic.org]

Skin

  • Skin Discoloration

    discoloration that indicates tissue damage can happen over time (within an hour to 72 hours after your baby is born). [my.clevelandclinic.org]

Musculoskeletal

  • Fracture

    In patients with intracranial hemorrhage or skull fractures, the incidence of subgaleal hemorrhage is increased 4. Signs include pallor on inspection. On examination, there may be tachycardia and/or hypotonia. [radiopaedia.org]

    Letture Consigliate Anderson LD, D’Alonzo RT (1974) Fractures of the odontoid process of the axis. [link.springer.com]

    Postmortem examination confirmed a massive subgaleal hemorrhage, with several diastatic fractures and anoxic-ischemic changes within the brain. [ncbi.nlm.nih.gov]

Face, Head & Neck

  • Scalp Mass

    A fluctuant scalp mass with increasing head circumference may be seen on palpation. As the potential space extends into the neck, a subgaleal hematoma may also extend into the neck. [radiopaedia.org]

Psychiatrical

  • Fear

    Appears confused, fearful or anxious. Seizures normally last between 30 seconds and two minutes. Any seizure lasting more than five minutes is a medical emergency, and you should call 911 immediately, especially if your child has trouble breathing. [my.clevelandclinic.org]

Treatment

Rarely, they become chronic and exceptionally they may require surgical treatment. [revistaneurocirugia.com]

Increased awareness of subgaleal hemorrhage should lead to earlier identification, referral and treatment, with resultant improved outcomes. Footnotes This article has been peer reviewed. Competing interests: None declared. Correspondence to: Dr. [ncbi.nlm.nih.gov]

Etiology

Etiology Bleeding occurs as a result of rupture to emissary veins which drain the scalp veins into the dural sinuses. [radiopaedia.org]

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