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Delayed Massive Expansion of Subgaleal Hematoma Complicated with Proptosis in Hemophilia B

Seon-Yeop Kim1, Han Gyu Cha2, Sun Young Jang3

  • 1Department of Neurosurgery, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.

Korean Journal of Neurotrauma
|November 11, 2021
PubMed

Insights

A rare case of proptosis (eye bulging) occurred in a boy due to a subgaleal hematoma (SGH). Prompt intervention and diagnosis of hemophilia B were crucial for preserving vision.

Area of Science:

  • Ophthalmology
  • Pediatrics
  • Hematology

Background:

  • Subgaleal hematoma (SGH) is a rare collection of blood between the galea aponeurotica and the periosteum.
  • Proptosis, or bulging of the eye, is an uncommon but serious complication of SGH, potentially leading to vision loss.

Observation:

  • A 12-year-old boy developed proptosis after a scalp injury, with a rapidly expanding subgaleal hematoma.
  • The proptosis resolved partially after emergent needle aspiration of the hematoma.

Findings:

  • The patient was diagnosed with coagulation factor IX deficiency (hemophilia B).
  • The supraorbital notch may serve as a pathway for SGH to extend into the orbit, causing proptosis.

Implications:

  • This case highlights the importance of recognizing SGH as a potential cause of proptosis in pediatric patients.
  • Early recognition and management of SGH, alongside hematological evaluation, are critical for preventing permanent visual impairment.

Keywords:
ExophthalmosHemophilia BOrbitSubgaleal hematoma

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