帽状腱膜下血腫
WordNet
- a localized swelling filled with blood (同)haematoma
Wikipedia preview
出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/03/11 00:08:41」(JST)
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| Subgaleal hemorrhage |
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Newborn Scalp bleeds
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| Classification and external resources |
| Specialty |
pediatrics |
| ICD-10 |
P12 |
| ICD-9-CM |
767.1 |
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[edit on Wikidata]
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Subgaleal hemorrhage or hematoma is bleeding in the potential space between the skull periosteum and the scalp galea aponeurosis.
Contents
- 1 Causes
- 2 Symptoms
- 3 Management
- 4 See also
- 5 References
Causes
The majority (90%) result from applying a vacuum to the head at delivery (Ventouse assisted delivery). The vacuum assist ruptures the emissary veins (connections between dural sinus and scalp veins) leading to accumulation of blood under the aponeurosis of the scalp muscle and superficial to the periosteum.[1] Subgaleal hematoma has a high frequency of occurrence of associated head trauma (40%), such as intracranial hemorrhage or skull fracture. The occurrence of these features does not correlate significantly with the severity of subgaleal hemorrhage.
Symptoms
The diagnosis is generally a clinical one, with a fluctuant boggy mass developing over the scalp (especially over the occiput) with superficial skin bruising. The swelling develops gradually 12–72 hours after delivery, although it may be noted immediately after delivery in severe cases. The hematoma spreads across the whole calvaria as its growth is insidious and may not be recognized for hours. If enough blood accumulates a visible fluid wave may be seen. Patients can develop raccoon eyes.
Patients with subgaleal hematoma may present with hemorrhagic shock.[2] The swelling may obscure the fontanel and cross suture lines (distinguishing it from cephalohematoma). Watch for significant hyperbilirubinemia. The long-term prognosis is generally good. Laboratory studies consist of a hematocrit evaluation.
Management
Management consists of vigilant observation over days to detect progression.The subgaleal space is capable of holding up to 50% of a newborn baby's blood and can therefore result in acute shock and death. Fluid bolus may be required if blood loss is significant and patient becomes tachycardic. Transfusion and phototherapy may be necessary. Investigation for coagulopathy may be indicated.
See also
- Caput succedaneum
- Cephal
- Cephalhematoma
- Hematoma
References
- ^ AAP Textbook of Pediatrics
- ^ Ronald S. Gibbs; David N. Danforth; Beth Y Karlan; Arthur F Haney (2008). Danforth's obstetrics and gynecology. Lippincott Williams & Wilkins. p. 470. ISBN 978-0-7817-6937-2. Retrieved 12 April 2010.
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Certain conditions originating in the perinatal period / fetal disease (P, 760–779)
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Maternal factors and
complications of pregnancy,
labour and delivery |
| placenta: |
- Placenta praevia
- Placental insufficiency
- Twin-to-twin transfusion syndrome
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| chorion/amnion: |
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| umbilical cord: |
- Umbilical cord prolapse
- Nuchal cord
- Single umbilical artery
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Length of gestation
and fetal growth |
- Small for gestational age/Large for gestational age
- Preterm birth/Postmature birth
- Intrauterine growth restriction
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| Birth trauma |
- scalp
- Cephalhematoma
- Chignon
- Caput succedaneum
- Subgaleal hemorrhage
- Brachial plexus lesion
- Erb's palsy
- Klumpke paralysis
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| By system |
| Respiratory |
- Intrauterine hypoxia
- Infant respiratory distress syndrome
- Transient tachypnea of the newborn
- Meconium aspiration syndrome
- pleural disease
- Pneumothorax
- Pneumomediastinum
- Wilson–Mikity syndrome
- Bronchopulmonary dysplasia
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| Cardiovascular |
- Pneumopericardium
- Persistent fetal circulation
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Haemorrhagic and
hematologic disease |
- Vitamin K deficiency
- Haemorrhagic disease of the newborn
- HDN
- ABO
- Anti-Kell
- Rh c
- Rh D
- Rh E
- Hydrops fetalis
- Hyperbilirubinemia
- Kernicterus
- Neonatal jaundice
- Velamentous cord insertion
- Intraventricular hemorrhage
- Germinal matrix hemorrhage
- Anemia of prematurity
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| Digestive |
- Ileus
- Necrotizing enterocolitis
- Meconium peritonitis
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Integument and
thermoregulation |
- Erythema toxicum
- Sclerema neonatorum
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| Nervous system |
- Periventricular leukomalacia
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| Musculoskeletal |
- Gray baby syndrome
- muscle tone
- Congenital hypertonia
- Congenital hypotonia
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| Infectious |
- Vertically transmitted infection
- Neonatal infection
- Congenital rubella syndrome
- Neonatal herpes simplex
- Mycoplasma hominis infection
- Ureaplasma urealyticum infection
- Omphalitis
- Neonatal sepsis
- Group B streptococcal infection
- Neonatal conjunctivitis
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| Other |
- Perinatal mortality
- Stillbirth
- Infant mortality
- Neonatal withdrawal
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UpToDate Contents
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English Journal
- [Spontaneous subgaleal haematoma presenting as an alteration in platelet function.]
- Esteller M, López N, Chiandetti A, Martínez-Roig A.SourceServicio de Pediatría, Hospital del Mar, Parc de Salut Mar, Barcelona, España.
- Anales de pediatria (Barcelona, Spain : 2003).An Pediatr (Barc).2011 Dec 27. [Epub ahead of print]
- PMID 22206880
- Minicraniotomy versus bur holes for evacuation of chronic subdural collections in infants-a preliminary single-institution experience.
- Klimo P Jr, Matthews A, Lew SM, Zwienenberg-Lee M, Kaufman BA.SourceLe Bonheur Children's Hospital, Memphis, Tennessee, USA.
- Journal of neurosurgery. Pediatrics.J Neurosurg Pediatr.2011 Nov;8(5):423-9.
- OBJECT: Various surgical interventions have been described to evacuate chronic subdural collections (CSCs) of infancy. These include transfontanel percutaneous aspiration, subdural drains, placement of bur hole(s) with or without a subdural drain, and shunting. Shunt placement typically provides goo
- PMID 22044363
Japanese Journal
- 鳥居 廣明,黒川 徹,藤澤 博亮,鈴木 倫保
- 山口医学 60(3), 63-67, 2011-06-30
- 症例は12歳男児.友人とふざけていて左側の髪を引っ張られ,その後に左側頭部に血腫が出現したとのことで救急外来を受診したが,経過観察となった.しかし受傷4日には皮下血腫は増大し,頭痛に吐気が加わり当科受診となった.CTにて帽状腱膜下血腫と診断し,血腫の吸引と弾性包帯での圧迫を行ったが,受傷5日に再増大し,強い頭痛のために入院となった.再度穿刺を行い,血腫の吸引,弾性包帯による圧迫,止血剤の投与にて保 …
- NAID 10029139873
- Neonatal subgaleal hemorrhage : Clinical presentation, treatment, and predictors of poor prognosis
- CHANG HUNG-YANG,PENG CHUN-CHIH,KAO HSIN-AN,HSU CHYONG-HSIN,HUNG HAN-YANG,CHANG JUI-HSING
- Pediatrics international : official journal of the Japan Pediatric Society 49(6), 903-907, 2007-12-01
- NAID 10024151813
Related Links
- Sir, Subgaleal hematoma is a potentially life-threatening extracranial bleed that occurs most commonly in neonates after difficult instrumental deliveries.[1] Its occurrence beyond the neonatal period is rare and is often associated with ...
- Find out all about subgaleal hematoma, including the most common causes and treatments from leading medical experts. ... Method for the Detection of a Subdural Hematoma Using a Handheld Hematoma Detector and Discriminator by ...
- Delayed Extensive Subgaleal Hematoma Following Minor Head Injury on Pediatric Oncall Home Pediatric Oncall Home Doctor Corner Home Parent Corner Home Child Corner Home | Doctor Corner Articles Diseases and ...
★リンクテーブル★
[★]
- (1) 小児では大きくなりやすい
- (2) 疼痛が激しい
- (3) 腫瘤は縫合線を越えない
- (4) 多くは頭蓋骨骨折を伴う
- (5) 大きい場合は穿刺廃液を要する
- a. (1)(2)
- b. (1)(5)
- c. (2)(3)
- d. (3)(4)
- e. (4)(5)
[★]
- 英
- subgaleal hematoma
- 関
- 頭血腫、産瘤、帽状腱膜
概念
- 帽状腱膜と骨膜の間に生じた血腫による。帽状腱膜は前頭部から側頭部、後頭部までおおっているため、血腫は頭部全体に及ぶ。
原因
治療