Hair Today; Scalped Tomorrow: Massive Subgaleal Haematoma Following Sudden Hair Pulling in an Adolescent in the Absence of Haematological Abnormality or Skull Fracture. Issue 5 (July 2016)

• Record Type: Journal Article
• Authors: Edmondson, Sarah-Jayne; Ramman, Saif; Hachach-Haram, Nadine; Bisarya, Kamal; Fu, Brian; Ong, Juling; Akhavani, Mo
• Is Part Of: Journal of craniofacial surgery. Volume 27:Issue 5(2016)
• Page Start: 1261
• Page End: 1262
• Publication Date: 2016-07
• Subjects: Bicoronal approach -- hair braiding -- hair pulling -- scalp trauma -- subgaleal haematoma; Facial bones -- Surgery -- Periodicals; Skull -- Surgery -- Periodicals; Face -- Surgery -- Periodicals; Surgery, Plastic -- Periodicals; 617.52
• DOI: 10.1097/SCS.0000000000002710
• Languages: English
• ISSNs: 1049-2275

Abstract

Abstract : Abstract: Subgaleal haematoma (SH) is a rare condition, most frequently observed in neonates as a complication of Ventouse-assisted delivery. There have been few patients reported beyond this period. Those that are present within the literature have typically resulted from significant blunt scalp trauma, with or without associated skull fracture. Those resulting secondary to relatively minor trauma, such as hair braiding or hair pulling, are rare but have been reported and are often associated with underlying haematological abnormalities or nonaccidental injury patients. Most patients resolve spontaneously and without complication. The authors report a rare patient of a delayed presentation of a massive SH in an adolescent following a seemingly innocuous episode of hair pulling whilst play-fighting, in the absence of any underlying haematological or anatomical abnormality. Due to the size of the SH and the appearance of large areas of calcification within the haematoma, early liaison with senior neuroradiologists and haematologists, to rule out underlying anatomical and haematological abnormalities, respectively, was essential to guide appropriate management. Our patient highlights the need for an awareness of the possible aetiologies of SH and the necessity of early active multidisciplinary team involvement in the management of such patients, which is critical to ensure optimum patient outcomes.