Bilateral proptosis from a subgaleal hematoma. Case report

Area of Science:

• Ophthalmology
• Neurosurgery
• Plastic Surgery

Background:

• Subgaleal hematomas can occur due to head trauma or surgical interventions.
• Compressive dressings are commonly used to manage hematomas and prevent further bleeding.
• Orbital complications from subgaleal hematomas are rare but can lead to significant morbidity.

Observation:

• A patient presented with bilateral proptosis, a condition characterized by the abnormal protrusion of one or both eyeballs.
• The proptosis was found to be caused by the orbital extension of a subgaleal hematoma.
• The hematoma was a result of a compressive dressing applied for its treatment.

Findings:

• The subgaleal hematoma extended into the orbit, causing bilateral proptosis.
• Orbital entry of the hematoma was suspected to have occurred via the lateral canthal region.
• The compressive dressing, intended for treatment, inadvertently facilitated this orbital extension.

Implications:

• This case highlights a rare but serious complication of subgaleal hematoma management.
• Ophthalmologists and surgeons should be aware of the potential for orbital involvement.
• Prompt recognition and management are crucial to prevent vision-threatening complications.