Scalp Hematoma

A 10-year-old girl came in last week with huge hematoma on her head caused by a motorcycle accident. A hematoma is a collection of blood outside the blood vessels. We get them all the time as bruises. This young girl’s was different in that it was a huge amount of blood that had collected on her head, just under her scalp. Her swollen head was very soft to the touch – in fact, it felt you were poking a water balloon.

She was sent home last week, and told to return if the swelling didn’t go down. Usually the blood just dissolves and in her case they were concerned about the risk of infection if they drained it.

She returned today and it hadn’t changed at all. Dr. Hewitt drained it by cutting a hole in her scalp and squeezing the blood out. At first it just poured out from the pressure but in the end he was massaging her scalp trying to get as much out as possible. They ended up with two bowl fulls of blood.

To this little girl’s credit, she didn’t complain, cry, or even shed a single tear. The only anesthetic she had was a bit of Lidocaine for the initial incision. When I photographed her after the procedure she managed to smile for the first time since I’d seen her. I’m sure the relief from the pressure on her head was a great feeling.

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