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Subgaleal hematoma with delayed proptosis and corneal ulceration
A J Pomeranz1, M S Ruttum, G J Harris
1Medical College of Wisconsin, Milwaukee, USA.
Insights
A subgaleal hematoma caused delayed proptosis (eye bulging) and a corneal ulcer in a child after head trauma. Factor VII deficiency and ibuprofen use may have worsened the hematoma, highlighting the need for careful subgaleal hematoma monitoring.
Area of Science:
- Ophthalmology
- Pediatrics
- Hematology
Background:
- Subgaleal hematomas can occur after head trauma in children.
- Proptosis, or bulging of the eye, is a rare but serious complication.
Observation:
- A child developed proptosis and a corneal ulcer 9 days after mild head trauma.
- The proptosis was attributed to a subgaleal hematoma.
Findings:
- The child had a heterozygous factor VII deficiency, a blood clotting disorder.
- Nonsteroidal anti-inflammatory drug (NSAID) use, specifically ibuprofen, was noted.
- The coagulopathy and NSAID use likely contributed to the hematoma's orbital extension.
Implications:
- Delayed proptosis can occur in pediatric subgaleal hematomas.
- Coagulopathies and certain medications may increase complication risk.
- Close monitoring of subgaleal hematomas is crucial for early detection of complications.
Abstract:
We report the delayed occurrence in a child of proptosis caused by a subgaleal hematoma. A corneal ulcer resulted from the proptosis, which developed 9 days after mild head trauma. Evaluation revealed a heterozygous factor VII deficiency. The coagulopathy and, more likely, the use of the nonsteroidal antiinflammatory drug ibuprofen may have contributed to the extension of the hematoma into the orbital space. Careful follow-up of patients with subgaleal hematomas is necessary because the development of proptosis may be delayed.