What Is a Cephalhematoma?

Scalp hematoma is mostly caused by blunt injury and scalp. According to the specific level of hematoma appearing in the scalp, it can be divided into three types: subcutaneous hematoma, subcapsular aponeurotic hematoma and subperiosteal hematoma. Generally, the scalp hematoma is small and can be absorbed by itself after 1 to 2 weeks without special treatment. Large hematomas often require puncture and extraction and local compression and bandaging. Puncture treatment is not effective, when the hematoma does not disappear or continues to increase, the hematoma can be removed by incision to stop bleeding. For subperiosteal hematoma with skull fracture, attention should be paid to the possibility of concurrent intracranial hematoma. All infected hematomas need to be opened and drained.

Basic Information

Visiting department

neurosurgery

Common locations

scalp

Common causes

Due to blunt injuries to the scalp

Common symptoms

Subcutaneous hematoma, subcapsular aponeurotic hematoma, subperiosteal hematoma

Causes of scalp hematoma

Scalp hematoma is mostly caused by blunt injury to the scalp.

Clinical manifestations of scalp hematoma

Subcutaneous hematoma

Because the subcutaneous tissue layer is tightly connected with the skin layer and the cap-shaped aponeurosis layer, the hematoma in this layer is not easy to spread. The tissue around the hematoma is swollen and thickened, and it has a feeling of depression. It is easy to be misdiagnosed as a depressed skull fracture. Sometimes a skull X-ray examination is required to rule out the possibility of fracture.

2. Subcapsular aponeurotic hematoma

Caused by ruptured arterioles or blood vessels. Because the subcapsular aponeurosis is loose, blood can easily expand in all directions, and the blood can fill the entire subcapsular aponeurosis, which significantly increases the top of the head, and its blood content can reach hundreds of milliliters.

3. Subperiosteal hematoma

It is more common after the skull undergoes obvious deformation during blunt injuries, such as newborn birth injuries, table tennis depression-like skull fractures in infants, and adult skull linear fractures. Bleeding due to local periosteal detachment. Because the periosteum is firmly attached to the cranial suture, the range of hematoma often does not exceed the cranial suture. In infants, the periphery and periosteum of old hematomas can thicken or ossify, forming bone cysts that contain old blood.

Scalp Hematoma Examination

Physical inspection

Feasible routine physical inspection.

2.CT inspection

CT is the most important imaging diagnostic method in head trauma. It is highly sensitive to fresh bleeding, and can show important lesions such as edema and increased intracranial pressure.

Scalp Hematoma Diagnosis

Diagnosis can be made based on the cause and clinical manifestations.

Scalp Hematoma Treatment

Smaller scalp hematomas can be absorbed by themselves within 1 to 2 weeks, and huge hematomas may take 4 to 6 weeks to absorb. Unless the scalp hematoma is large, it can usually be absorbed by itself. Appropriate local pressure bandaging is helpful to prevent the expansion of hematoma. To avoid infection, puncture aspiration is generally not used. When dealing with scalp hematomas, we must focus on the possibility of skull injury and even brain injury. The treatment of scalp hematoma has the following points:

(1) When scalp hematoma occurs, do not apply bruised hematoma locally or massage by rubbing, as this will make the bleeding worse. Gauze bandages can be used for topical pressure bandaging or cold water for external application with ice cubes, ice water or hot water bags to promote blood vessel constriction and prevent further bleeding.

(2) After 24 hours, apply medicinal wine, safflower oil, and heat to promote hematoma absorption. Small hematomas can be absorbed and heal after a few days.

(3) Large hematomas are not easily absorbed, and hair can be shaved. After local disinfection, repeated puncture with an injection needle is used to extract blood, but it is forbidden to puncture and bleed with a needle.

(4) Huge hematoma, when the above method is ineffective, it should be sent to the hospital for surgical incision to stop bleeding. If the hematoma is infected with pus, it should be surgically opened and treated with medicine.

(5) When scalp hematoma occurs, you should also be alert for the presence of intracranial hematoma, concussion, or contusion. Allow the patient to rest quietly and closely observe the changes in the condition within 24 hours. If you notice obvious headaches, nausea, vomiting, irritability or gradual loss of consciousness, the pupils are not the same, and the ears and nosebleeds should be consulted in time or sent to the hospital Further diagnosis and treatment.