scalp hematoma
Introduction
Introduction More common in blunt injury due to deformation or fracture of the skull. Such as infants and children's table tennis-like sag fractures and adult skull fractures often accompanied by such hematoma. Because the periosteum is firmly attached to the cranial suture, the hematoma often does not exceed the cranial suture. In infants and young children, the periplasm and periosteum of the old hematoma can be calcified or ossified, and even form a bone cyst containing old blood. According to the specific level of hematoma appearing in the scalp, it can be divided into subcutaneous hematoma, subarachnoid hematoma and subperiosteal hematoma. Effective prevention of injury can avoid the disease.
Cause
Cause
Because the connection between the subcutaneous tissue and the skin layer and the aponeurotic layer is tight, the hematoma in this layer is not easily diffused and the range is limited. The soft tissue around the hematoma is swollen and has a feeling of depression, which is caused by the rupture of small arteries or blood vessels in the layer. The lower layer of the aponeurotic aponeurosis is loose, and the hematoma easily spreads and even spreads to the entire lower layer of the aponeurotic aponeurosis, which can contain up to several hundred milliliters of blood.
Examine
an examination
Related inspection
Scalp examination blood routine
Diagnosis: According to the specific level of hematoma appearing in the scalp, it can be divided into subcutaneous hematoma, subarachnoid hematoma and subperiosteal hematoma.
1. Subcutaneous hematoma: Because the connection between the subcutaneous tissue and the skin layer and the aponeurotic layer is tight, the hematoma in this layer is not easy to spread and the scope is limited. The soft tissue around the hematoma is swollen, and there is a sense of depression and tenderness. It is easy to be confused with the sag fracture. Sometimes it needs to be confirmed by X-ray examination of the skull.
2. Capular subdural hematoma: caused by rupture of small arteries or blood vessels in this layer. The lower layer of the aponeurotic aponeurosis is loose, and the hematoma easily spreads and even spreads to the entire lower layer of the aponeurotic aponeurosis. The blood content can be as much as several hundred milliliters, the tension is low, and the pain is light.
3. Subperiosteal hematoma: bleeding is mostly caused by platelet hemorrhage or periosteal stripping. The range is limited to the bone seam and the texture is hard.
Diagnosis
Differential diagnosis
Differential diagnosis: According to various symptoms and signs, it can be differentiated from scalp laceration and scalp avulsion.
1. Scalp laceration: The scalp is a specialized skin that contains a large number of hair follicles, sweat glands and sebaceous glands. It is easy to hide dirt and bacteria and is prone to infection. However, the blood circulation of the scalp is very rich. Although the scalp is lacerated, as long as it can be thoroughly debrided in time, the infection is rare. In each layer of the scalp, the cap-like aponeurosis is a tough aponeurosis that is not only an important structure for maintaining scalp tension, but also a barrier against the invasion of superficial infections into the brain. When the scalp laceration is shallow and does not damage the cap-like aponeurosis, the rupture is not easy to open, and the vascular end is difficult to retract and stop bleeding, and the bleeding is more. If the aponeurotic aponeurosis breaks, the wound is clearly ruptured, and the damaged vascular end is retracted with the wound and self-coagulated, so less bleeding.
2. Scalp avulsion: A scalp avulsion is a serious scalp injury, almost always because a woman with a bun has accidentally rolled her hair into a rotating wheel. Since the epidermis layer, the subcutaneous tissue layer and the cap-like aponeurosis layer are closely connected together, under the strong traction, the scalp is often avulsed from the full layer of the decidual aponeurotic space, and sometimes the partial periosteum is also avulsed. To make the skull bare. The extent of scalp avulsion is related to the area of the hair root that is involved. In severe cases, it can reach the coverage area of the entire cap-shaped diaphragm, from the front to the upper eyelid and the nasal root, and then to the hairline, both sides of the ear and even the cheeks. The patient has a large amount of blood loss, which can cause shock, but less combined with skull fracture or brain injury.
