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A subgaleal hemorrhage is bleeding between the skull and scalp, leading to swelling. It is possible to bleed profusely from ruptured blood vessels below the scalp, potentially causing shock in the patient due to blood loss. This condition is most commonly seen after traumatic birth, although it can also be caused by a fall or blow to the head. Patients with subgaleal hemorrhages may need to spend time in the hospital, where nurses and doctors can monitor them for signs of complications until they are stable enough to go home.
This medical condition is usually caused by trauma and stress to the head, breaking blood vessels and causing them to bleed into the space between the skull and the scalp. Some swelling may become apparent almost immediately, and over the course of several days, the scalp can swell significantly and the patient's head may appear misshapen or lopsided. The area of swelling is soft and may be tender. Patients can feel dizzy or lightheaded when they have a subgaleal hemorrhage.
In newborns, subgaleal hemorrhage is of special concern, because as much as 50% of the blood volume can be involved. Losing this much blood will result in shock. The patient's heart will not beat regularly, seizures may occur, and the patient can lose consciousness. When subgaleal hemorrhage is suspected in an infant, it may be necessary to transfuse blood or use fluid boluses to keep the blood pressure up and prevent shock. Patients also need to be kept warm.
The ruptured vessels will eventually heal, and the body can transport the leaked blood away for disposal. The swelling resolves over time and the patient should not experience any lingering health problems. Concerns arise if the patient lost enough blood to go into shock, as it is possible the patient may experience brain damage and other problems. Some neonatal patients do not recover from subgaleal hemorrhage, even with very attentive care from medical providers.
Any time a swelling of the head is visible, it should be evaluated, even if a person does not remember a fall or blow. This is especially important if patients appear to have an altered level of consciousness or express disorientation and confusion. Doctors can examine the patient and use medical imaging studies to find out where the swelling is coming from. Treatment options can vary, depending on the cause, but generally, more choices are available when the problem is caught early. Failure to treat injuries to the head can result in severe complications, and may expose patients to risks like coma and death.