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Subgaleal hematoma with orbital extension

Case contributed by Abiola Ayodele
Diagnosis certain

Presentation

Increasing head size and inability to see following head trauma. The patient has a known bleeding disorder.

Patient Data

Age: 15 years
Gender: Male

CT shows massive mixed density subgaleal hematoma with bilateral orbital subperiosteal extension. Proptosis is noted bilaterally. The brain parenchyma appears unremarkable. No skull fracture is seen.

Case Discussion

Subgaleal hematoma is bleeding into the potential space between the periosteum and the galeal aponeurosis. An orbital subperiosteal extension may occur following massive subgaleal hematoma due to leakage of blood into the orbital periosteal space through the galeal attachment to the orbital ridge1. This may cause chemosis, proptosis, exposure keratopathy, and blindness2.

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