scholarly journals Massive subgaleal hematoma in a 62-year-old man treated with apixaban as a consequence of mild head trauma

Folia Medica ◽  
2021 ◽  
Vol 63 (4) ◽  
pp. 613-617
Author(s):  
Diamantoula Pagkou ◽  
Theodosios Papavramidis ◽  
Xanthippi Mavropoulou ◽  
Moysis Moysidis ◽  
Ioannis Patsalas
Keyword(s):  
Skull Base ◽  
Head Trauma ◽  
Therapeutic Strategy ◽  
Chronic Atrial Fibrillation ◽  
Hair Pulling ◽  
The Third ◽  
Subgaleal Hematoma ◽  
Car Accident ◽  
Subgaleal Space ◽  
Full Body

Subgaleal hematoma, accumulation of blood in the loose areolar tissue of the subgaleal space of the skull, is considered the most catastrophic complication of instrumental delivery. It is a rare finding in older ages, usually associated with coagulation disorders, severe head trauma leading to skull base fractures and accidental or abusive hair pulling. Complications include periorbital necrotising fasciitis, permanent blindness, infections and, in extreme rare cases, airway obstruction. Most cases of subgaleal hematoma resolve spontaneously, without the need of aspiration or drainage. We present here the case of a 62-year-old male on anticoagulant therapy with apixaban for chronic atrial fibrillation, who came to the emergency department after a car accident suffering from mild head trauma. The patient was complaining of a diffuse headache and physical examination showed a large ecchymosis and edema on the frontal area of the head. His neurological examination was unremarkable. Full-body computed tomography (CT) revealed a fracture of the third right rib. Twelve hours after admission, due to an excessive decrease of hematocrit, a second CT was performed. Although the images didn’t show intracranial hemorrhage or skull base fractures, a large and diffuse hematoma of the subaponeurotic space was observed and the diagnosis of subgaleal hematoma was confirmed. Massive subgaleal hematoma after mild head trauma is rather infrequent. Early diagnosis improves outcomes and can avert serious complications. Therapeutic strategy should be based on the severity of each case. In our case, conservative treatment appeared to be a valid alternative to surgery, as hematoma resolved spontaneously within 10 days. It is noteworthy that the use of anticoagulation is the only evident factor that could have been the precipitating factor for the development of the hematoma in our patient.

scholarly journals Therapeutic Strategy for Skull Base Tumors

2020 ◽  
Vol 29 (1) ◽  
pp. 17-24
Author(s):  
Takeo Goto ◽  
Kenji Ohata
Keyword(s):  
Skull Base ◽  
Therapeutic Strategy ◽  
Skull Base Tumors

scholarly journals Large subgaleal hematoma producing turban head in 10 year boy with cerebral palsy: rare case report with review of literature

2016 ◽  
Vol 30 (4) ◽  
pp. 562-565
Author(s):  
Praveen Kumar Tripathi ◽  
Vardan Kulshreshtha ◽  
Gaurav Jaiswal ◽  
Tarun Kumar Gupta
Keyword(s):  
Cerebral Palsy ◽  
Severe Pain ◽  
Rare Case ◽  
Parietal Region ◽  
Review Of Literature ◽  
Large Space ◽  
Rare Case Report ◽  
Subgaleal Hematoma ◽  
Subgaleal Space ◽  
Progressive Enlargement

Abstract Subgaleal hematomas (SGHs) are not uncommon. Because the subgaleal space has no anatomical boundaries, SGHs usually involve a large space and are typically limited to the parietal region. Cases of SGHs involving whole of head are relatively rare. In this study we report a rare case of massive enlargement of head after SGH causing severe pain and giving an appearance of turban. A 10 year old, male patient with cerebral palsy presented with progressive enlargement of head attaining a size of turban due to habitual head banging and self-punching overhead. SGH drainage and hematoma aspiration were performed and the patient’s head size was restored.

scholarly journals Modified one-piece extended transbasal approach for translamina terminalis resection of retrochiasmatic third ventricular craniopharyngioma

2013 ◽  
Vol 34 (v1supplement) ◽  
pp. 1 ◽  
Author(s):  
James K. Liu
Keyword(s):  
Skull Base ◽  
Third Ventricle ◽  
Blind Spot ◽  
Anterior Wall ◽  
Anterolateral Approach ◽  
Lamina Terminalis ◽  
Base Approach ◽  
The Third ◽  
Skull Base Approach ◽  
Midline Approach

Retrochiasmatic third ventricular craniopharyngiomas are formidable tumors to remove surgically. Access to the third ventricle can be achieved through the lamina terminalis corridor. A skull base approach to the lamina terminalis can be performed using either an anterolateral approach (orbitozygomatic, pterional, supraorbital) or a midline approach (extended transbasal, subfrontal). The major disadvantage of an anterolateral approach is the lack of visualization of the ipsilateral wall of the third ventricle and hypothalamus. However, a midline transbasal approach eliminates this blind spot thereby providing direct visualization of both ependymal walls for safe dissection of the tumor. In this operative video manuscript, the author demonstrates an illustrative step-by-step technique for translamina terminalis resection of a retrochiasmatic retroinfundibular craniopharyngioma within the third ventricle via a modified one-piece extended transbasal approach. This approach uses the standard bifrontal craniotomy and incorporates the anterior wall of the frontal sinus as a one-piece flap. The inferior limit of the osteotomy is based along the coronal contour of the anterior skull base which eliminates any bony overhang that can obstruct the line of sight to the lamina terminalis. Additional removal of the supraorbital bar is not necessary. The operative technique for this skull base approach and surgical nuances for craniopharyngioma resection are illustrated in this video atlas.The video can be found here: http://youtu.be/E3Bsp6dUdAE.

Massive subgaleal hematoma following minor head trauma

1991 ◽  
Vol 9 ◽  
pp. 33-35 ◽  
Author(s):  
David S. Cooling ◽  
Peter Viccellio
Keyword(s):  
Head Trauma ◽  
Minor Head Trauma ◽  
Subgaleal Hematoma

scholarly journals Surgical management of axis' traumatic spondylolisthesis (Hangman's frature)

2004 ◽  
Vol 62 (3b) ◽  
pp. 821-826 ◽  
Author(s):  
José Luiz Romeo Boullosa ◽  
Benedicto Oscar Colli ◽  
Carlos Gilberto Carlotti Jr ◽  
Koji Tanaka ◽  
Marcius Benigno Marques dos Santos
Keyword(s):  
Surgical Treatment ◽  
Head Trauma ◽  
Skull Fracture ◽  
Pedicle Screws ◽  
Clinical Treatment ◽  
Multiple Fractures ◽  
Halo Vest ◽  
Post Surgery ◽  
Car Accident ◽  
Traumatic Spondylolisthesis

OBJECTIVE: To evaluate the results of surgical treatment using pedicle screws going through C2 pedicles for fixating the spondylolisthesis of the axis in patients who presented pseudoarthrosis after clinical treatment, or who have no condition for fixation with "halo vest", due to serious head trauma. METHOD: Ten patients have been operated from June 1998 to April 2002, nine suffering from traumatic spondylolisthesis of the axis caused by car accident and one horse fall. Four of those patients have undergone clinical treatment and presented signs of pseudoarthrosis, suffering intense pain at the movement of the cervical spine. Two of them presented moderate head trauma with multiple fractures of the skull. Another one was submitted to a surgical treatment for an acute extradural hematoma. Three patients presented a serious dislocation of C2 over C3. The patients were submitted to arthrodesis of the fractures with two screws, placed on the C2 pedicles, which allowed a better approximation of the fractures with the alignment of C2-C3. Two other patients required additional fixation with a plate on the lateral masses of C3. RESULTS: Nine patients had a good post surgery evolution with satisfactory consolidation of the fractures and disappearance of the symptoms. One patient had a good evolution but still has cervical pain resulting from strain. CONCLUSION: The fixation of the traumatic spondylolisthesis of the axis using screws in C2 pedicles and through fractures traces is a good option for treating patients who present pseudoarthrosis after clinical treatment or who present contraindication to the "halo vest", such as skull fracture or great lacerations in the scalp.

scholarly journals Trauma craneoencefálico severo y shock hipovolémico. Reporte de un caso

2019 ◽  
Vol 3 (2) ◽  
pp. 23
Author(s):  
Vielka Stefania Briones Briones ◽  
Shirley Alejandra Prías Páez ◽  
Melania Del Consuelo Alcívar García
Keyword(s):  
Head Trauma ◽  
Hypovolemic Shock ◽  
Fire Department ◽  
Initial Assessment ◽  
Health Unit ◽  
Facial Fractures ◽  
Neurological Sequelae ◽  
Brain Mass ◽  
Palabras Clave ◽  
Car Accident

  El objetivo del presente trabajo es describir el caso de un paciente con un trauma craneoencefálico severo y shock hipovolémico para el manejo y atención de este tipo de patología en edades pediátricas. Se presenta el caso de un paciente masculino de 5 años de edad, que llega a la emergencia de una unidad de salud por cuerpo de bomberos tras accidente automovilístico caracterizado por fracturas craneales y faciales con exposición de masa encefálica. Este trabajo destaca la valoración inicial de la gravedad del traumatismo craneoencefálico en la primera hora mediante la escala de Glasgow adaptada a la edad pediátrica, que permite monitorizar la evolución, intercambiar información y orientar el tratamiento y el pronóstico y así disminuir el riesgo de secuelas neurológicas.   Palabras clave: Traumatismo craneoencefálico, choque, fracturas craneales.   Abstract The aim of the present work is to describe the case of a patient with severe head trauma and hypovolemic shock for the management and care of this type of pathology in pediatric ages. The case of a 5-year-old male patient is presented, who arrives at the emergency of a health unit by the fire department after a car accident characterized by cranial and facial fractures with exposure of a brain mass. This work highlights the initial assessment of the severity of head trauma in the first hour using the Glasgow scale adapted to pediatric age, which allows monitoring the evolution, exchanging information and orienting treatment and prognosis and thus reducing the risk of neurological sequelae.   Keywords: Head trauma, shock, cranial fractures.  

scholarly journals Pneumocephalus complicating frontal sinus osteoma

1998 ◽  
Vol 3 (4) ◽  
pp. 29-31
Author(s):  
S. Simarak ◽  
B. Suraprasit ◽  
A. Senatham
Keyword(s):  
Skull Base ◽  
Head Trauma ◽  
Paranasal Sinuses ◽  
Frontal Sinus ◽  
Pituitary Tumour ◽  
Common Causes ◽  
Benign Tumours

Pneumocephalus is most frequently caused by head trauma, especially to the paranasal sinuses and mastoid areas. Tumours of the skull base, such as osteoma or pituitary tumour, are less common causes. Since osteoma is one of the more common benign tumours of the nose and paranasal area with the frontal sinus being its most frequent location, special attention should be paid to the examination of this area for frontal osteoma in patients presenting with spontaneous pneumocephalus.

scholarly journals Emergent Skull-Base Mesh Cranioplasty for Large Defects Using Titanium Implants in Severe Head Trauma: A Case Report of Difficult Cranionasal Separation

2017 ◽  
Vol 78 (S 01) ◽  
pp. S1-S156
Author(s):  
Akshay Sharma ◽  
Christina Wright ◽  
Catherine Weng ◽  
Sunil Manjila ◽  
Freedom Johnson ◽  
...  
Keyword(s):  
Case Report ◽  
Skull Base ◽  
Head Trauma ◽  
Titanium Implants ◽  
Severe Head Trauma

scholarly journals Subgaleal hematoma evacuation in a pediatric patient: A case report and review of the literature

2020 ◽  
Vol 11 ◽  
pp. 243
Author(s):  
Tye Patchana ◽  
Hammad Ghanchi ◽  
Taha Taka ◽  
Mark Calayag
Keyword(s):  
Pediatric Patients ◽  
Neonatal Period ◽  
Clinical Course ◽  
African American Female ◽  
Review Of The Literature ◽  
Hair Pulling ◽  
Imaging Characteristics ◽  
Subgaleal Hematoma ◽  
History Of

Background: Subgaleal hematoma (SGH) is generally documented within the neonatal period and is rarely reported as a result of trauma or hair braiding in children. While rare, complications of SGH can result in ophthalmoplegia, proptosis, visual deficit, and corneal ulceration secondary to hematoma extension into the orbit. Although conservative treatment is preferential, expanding SGH should be aspirated to reduce complications associated with further expansion. Case Description: A 12-year-old African-American female with no recent history of trauma presented with a chief complaint of headache along with a 2-day history of enlarging 2–3 cm ballotable bilateral frontal mass. Hematological workup was negative. The patient’s family confirmed a long history of hair braiding. The patient was initially prescribed a period of observation but returned 1-week later with enlarging SGH, necessitating surgical aspiration. Conclusion: SGH is rare past the neonatal period, but can be found in pediatric and adolescent patients secondary to trauma or hair pulling. Standard workup includes evaluation of the patient’s hematological profile for bleeding or coagulation deficits, as well as evaluation for child abuse. Although most cases of SGH resolve spontaneously over the course of several weeks, close follow-up is recommended. The authors present a case of a 12-year-old female presenting with enlarging subgaleal hemorrhages who underwent surgical aspiration and drainage without recurrence. A literature review was also conducted with 32 pediatric cases identified, 20 of which were related to hair pulling, combing, or braiding. We review the clinical course, imaging characteristics, surgical management, as well as a review of the literature involving subgaleal hemorrhage in pediatric patients and hair pulling.

scholarly journals Simultaneous repair of the skull base and the frontal lobe defect using CAD-CAM technology

2021 ◽  
Author(s):  
OV Ivanov
Keyword(s):  
Traumatic Brain Injury ◽  
Cerebrospinal Fluid ◽  
Skull Base ◽  
Postoperative Period ◽  
Revision Surgery ◽  
Frontal Bone ◽  
Cerebrospinal Fluid Rhinorrhea ◽  
Cad Cam ◽  
Cosmetic Effect ◽  
Car Accident

Many patients with traumatic brain injury develop complications in the postoperative period. The article describes a case of revision surgery in a female patient with cerebrospinal fluid rhinorrhea following a severe car accident. During one surgery, the skull base and the frontal bone defect were repaired and a lumboperitoneal shunt was placed. The skull base was repaired using an autologous musculoaponeurotic graft. For a better cosmetic effect, the implant was designed using CADCAM technologies. The patient had a relapse of the leak in the postoperative period, which required revision surgery (multilayer reconstruction using a fibrin-thrombin sponge). The patient was followed up for 2 years, with no relapse. The desired clinical and cosmetic effects were successfully achieved.

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