What's wrong with the swelling on my scalp?

A swelling on the scalp is called a scalp hematoma, which is usually caused by blunt force trauma or may be caused by bumps and bruises. Depending on the condition of the disease, it can be divided into three types: subcutaneous hematoma, subgaleal hematoma and subperiosteal hematoma. Small scalp hematoma does not require special treatment, and severe ones may even require craniotomy to stop the bleeding. So, what does it mean if there is a swelling on your scalp? Let’s take a closer look below.

Causes

Scalp hematoma is mostly caused by blunt trauma to the scalp.

Clinical manifestations

1. Subcutaneous hematoma

Because the subcutaneous tissue layer is closely connected to the skin layer and the galea aponeurotica layer, the hematoma in this layer is not easy to spread. The tissue around the hematoma is swollen and thickened, and feels sunken when touched, which can easily be misdiagnosed as a depressed skull fracture. Sometimes a skull X-ray is needed to rule out the possibility of a fracture.

2. Subgaleal hematoma

Caused by the rupture of a small artery or blood vessel. Because the tissue under the galea aponeurotica is loose, blood can easily spread in all directions. The blood can fill the entire subgalea aponeurotica, significantly enlarging the top of the head, and the blood volume can reach hundreds of milliliters.

3. Subperiosteal hematoma

It is more common after the head is significantly deformed due to blunt trauma, such as birth injuries in newborns, ping-pong ball-like depressed skull fractures in infants and young children, and linear skull fractures in adults. Bleeding occurs due to local periosteal stripping. Since the periosteum is firmly attached to the cranial sutures, the range of the hematoma usually does not exceed the cranial sutures. In infants, the periphery and periosteum of old hematomas may thicken or ossify, forming bone cysts containing old blood.

examine

1. Physical inspection

Routine physical examination is possible.

2. CT examination

CT is the most important imaging diagnostic method in head trauma. It is highly sensitive to fresh bleeding and can show important lesions such as edema and brain herniation secondary to increased intracranial pressure.

diagnosis

The diagnosis can be made based on the cause and clinical manifestations.

treat

Smaller scalp hematomas can be absorbed on their own in 1 to 2 weeks, while large hematomas may take 4 to 6 weeks to be absorbed. Unless the scalp hematoma is large, it can usually be absorbed on its own. Appropriate local pressure bandage can help prevent the expansion of hematoma. To avoid infection, puncture aspiration is generally not used. When treating a scalp hematoma, it is important to consider the possibility of skull injury or even brain injury. The treatment of scalp hematoma includes the following:

(1) When a scalp hematoma occurs, do not apply medicinal wine to the hematoma area or massage it, as this will make the bleeding more severe. You can apply pressure with a gauze bandage or apply ice cubes, ice water, or a hot water bottle filled with cold water to the area to promote blood vessel contraction and stop further bleeding.

(2) After 24 hours, you can apply medicinal wine, safflower oil, and use hot compresses to promote the absorption of the hematoma. Smaller hematomas can usually be absorbed and healed after a few days.

(3) If a larger hematoma is not easily absorbed, you can shave off the hair, disinfect the area, and then use a needle to repeatedly puncture and draw out the blood. However, you are prohibited from puncturing and bleeding with a needle at will.

(4) For huge hematomas, if the above treatment methods are ineffective, the patient should be sent to the hospital for surgery to stop the bleeding. If the hematoma becomes infected and festers, surgery should be performed to incise and apply medication for treatment.

(5) If a scalp hematoma occurs, one should also be alert to the possibility of intracranial hematoma, concussion, or cerebral contusion. Allow the patient to rest quietly and observe changes in the condition closely for 24 hours. If obvious headache, nausea, vomiting, irritability or gradual loss of consciousness, unequal pupils, ear or nose bleeding, etc. are found, consult a doctor or send to the hospital for further diagnosis and treatment.