Subgaleal Hemorrhage

Subgaleal hemorrhage is a rare but serious condition that occurs when blood collects in the space between the scalp and the skull. This space is called the subgaleal space, and it contains blood vessels that can bleed extensively if injured. The condition mainly affects newborns, especially those who have experienced difficult deliveries involving vacuum extraction or forceps. The bleeding can cause the scalp to swell and may lead to significant blood loss, which can affect the baby's overall health. Because the bleeding is under the scalp, it can be hard to see at first but may cause the head to appear unusually large or soft. This condition involves the circulatory system and can lead to serious complications if not recognized and treated promptly.

Subgaleal hemorrhage is defined as bleeding into the potential space between the periosteum of the skull and the galea aponeurotica. It typically results from rupture of the emissary veins that connect the dural sinuses to the scalp veins, often due to traumatic delivery methods such as vacuum-assisted or forceps-assisted birth. The hemorrhage can accumulate large volumes of blood, leading to hypovolemic shock and significant morbidity or mortality in neonates. Clinically, it presents with a diffuse, fluctuant scalp swelling that crosses suture lines, distinguishing it from cephalohematoma. The condition requires urgent recognition due to the risk of rapid blood loss and associated hemodynamic instability. Diagnosis and management are critical to prevent complications such as anemia, coagulopathy, and death.