Subgaleal hematoma

Case contributed by Fakhry Mahmoud Ebouda
Diagnosis certain

Presentation

Abnormal head shape and swelling after vacuum delivery at the hospital.

Patient Data

Age: 2 days
Gender: Male
x-ray

Extracranial soft tissue swelling.

ct

Large mainly left-sided subgaleal hematoma with smaller contralateral extension to the right side. It extends beyond the sagittal suture. It shows fluid/fluid level likely to be blood degradation on the left side of the scalp.

Ill-defined hyperdensities are seen in the posterior fossa and occipital lobes suggesting subarachnoid bleed.

Attenuated cerebral ventricles with effaced cortical sulci likely owing to diffuse cerebral edema.

Bilateral wormian bones are seen in the lambdoid suture.

Case Discussion

Large scalp soft tissue swelling, mainly on the left parietal region. It extends to the right parietal region exceeding the sagittal suture. Crossing the suture is the hallmark and differentiating point of subgaleal hematoma from cephalohematoma. 

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