Neonatal Subgaleal Hemorrhage: Narrative Review
https://doi.org/10.15690/vsp.v24i3.2901
Abstract
Subgaleal hemorrhage (SH) is a blood pooling between epicranial aponeurosis and skull bones periosteum. It is a fluctuating mass on the scalp spreading through the cranial sutures. Children with SH may have anemia, hyperbilirubinemia, pain syndrome, and seizures. Newborns with SH may require monitoring and treatment in intensive care unit. Ophthalmoplegia, eyelid ptosis, and visual impairment are possible if SH is spreading to the orbital region. In case of large SH, blood can penetrate below zygomatic arch, thus, the child may have difficulties with breathing, apnea, and soft tissue necrosis. Up to 250–300 ml of blood can accumulate in subaponeurotic space in newborns. Therefore, large SH may lead to hypovolemia, arterial hypotension, coagulopathy, and hemorrhagic shock. Children with SH may have subdural hematomas, cerebellar tentorium ruptures, skull fractures. Mortality rate among infants with SH admitted to intensive care unit is 12–14%. Differential diagnosis should be performed with cephalhematoma and large caput succedaneum. Ultrasound examination allows us to differentiate these conditions, determine further tactics of instrumental imaging and patient management. Neonatologists, intensivists, and pediatricians can master the ultrasound examination technique in children. Small SH can reabsorb on their own within few weeks. Surgical treatment may be required in case of large hemorrhages due to the high risk of complications (suppuration, necrosis, calcifications, and visual impairments).
About the Author
Andrey F. Kiosov
Pavlov First Saint Petersburg State Medical University
Russian Federation
Disclosure of interest:
Russian Federation
Saint Petersburg
Disclosure of interest:
None
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Review
For citations:
Kiosov A.F. Neonatal Subgaleal Hemorrhage: Narrative Review. Current Pediatrics. 2025;24(3):140-145. (In Russ.) https://doi.org/10.15690/vsp.v24i3.2901
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