Case Report / Olgu Sunumu 33 © Copyright 2017 by Society of Pediatric Emergency and Intensive Care Medicine Journal of Pediatric Emergency and Pediatric Intensive Care published by Galenos Yayınevi. Address for Correspondence/Yazışma Adresi: Anıl Er MD, Dokuz Eylül University Faculty of Medicine, Division of Pediatric Emergency Medicine, İzmir, Turkey E-mail: anler.278@gmail.com Received/Geliş Tarihi: 07.12.2016 Accepted/Kabul Tarihi: 06.01.2017 Introduction Subgaleal hematoma (SGH) is a well-known condition in neonates especially after prolonged or instrumental delivery, but it has been rarely reported in childhood. 1-5 This condition is usually secondary to minor head trauma and an interesting mechanism of injury is hair pulling. 3,4,6-8 In spite of its benign course, subgaleal hematomas may complicate by vision or life- threatening events. 6,8-11 In this paper, we present a case of uncomplicated SGH after hair pulling and aimed to describe its pathogenesis and management. Case An 8-year-old girl was admitted to the emergency department with progressive right scalp swelling and headache. She denied head trauma, but she explained that schoolmates had strongly pulled her hair 11 days ago. She had realized scalp swelling two days after hair pulling and headache has arisen next day. On initial assessment, vital signs were stable (heart rate: 84 beats per minute, respiratory rate: 18/min, blood pressure: 90/55mmHg) and Glasgow Coma Scale score was 15. Physical examination revealed a fluctuant and mildly tender scalp swelling extending from forehead to neck on the right side of the head. Extra-ocular muscle movements were intact and there was no proptosis or facial edema. Neurological evaluation was normal. Neither her medical history nor family history indicated any sign and symptom of coagulation disorders. Also, she did not take any medications such as acetylsalicylate. Complete blood count was normal with a hemoglobin level of 12.6 g/dL, hematocrit 37% and platelet 294.000/mm³. Aggregated thrombocytes were seen on peripheral blood smear microscopy. Prothrombin time and partial thromboplastin time were 12 seconds and 27 seconds, respectively. Computed tomography (CT) of the head showed diffuse subgaleal heterogeneous fluid collection without Subgaleal hematoma is defined as blood collection within the loose areolar tissue of the scalp. The major cause of subgaleal hematoma in children is minor head trauma. It is characterized by diffuse scalp swelling crossing the suture lines which usually results in spontaneous recovery. Underlying coagulopathy should be evaluated in case of subgaleal hematoma after a trivial trauma. Another consideration for physicians, who face with a case of subgaleal hematoma, is complications such as proptosis, keratitis, and even airway compromise as a life-threatening event. Here, we present a case of uneventfully resolved subgaleal hematoma related with hair pulling. Keywords: Hematoma, pediatric, scalp, trauma Subgaleal hematom, saçlı derideki gevşek gözenekli dokuda kan birikimi olarak tanımlanmaktadır. Çocuklarda subgaleal hematomun en önemli nedeni hafif kafa travmasıdır. Saçlı deride sütür hatlarını geçen ve kendiliğinden gerileyen şişlik ile karakterizedir. Çocuklarda önemsiz travmalar sonrası gelişen subgaleal hematomlarda altta yatan koagülasyon bozukluğu varlığı araştırılmalıdır. Bu olgularla karşılaşan hekimlerin dikkat etmesi gereken diğer bir nokta ise subgaleal hematomun propitozis, keratit ve hatta havayolu tıkanıklığı gibi yaşamı tehdit eden komplikasyonlardır. Burada komplikasyonsuz iyileşen saç çekmeye bağlı bir subgaleal hematom olgusu sunulmuştur. Anahtar Kelimeler: Hematom, pediyatrik, saçlı deri, travma Abstract Öz 1 Dokuz Eylül University Faculty of Medicine, Division of Pediatric Emergency Medicine, İzmir, Turkey 2 Dokuz Eylül University Faculty of Medicine, Department of Emergency Medicine, İzmir, Turkey Anıl Er 1 , Aykut Çağlar 1 , Fatma Akgül 1 , Emel Ulusoy 1 , Emre Karslı 2 , Durgül Yılmaz 1 , Murat Duman 1 Çocuklarda Subgaleal Hematomun Nadir Bir Nedeni: Saç Çekme A Rare Cause of Subgaleal Hematoma in Children: Hair Pulling DOI: 10.4274/cayd.54254 J Pediatr Emerg Intensive Care Med 2017;4:33-35