Neonatal subcutaneous hematoma

I believe most people know that newborns are very ugly when they are just born. The whole skin of the baby is wrinkled. In addition, the baby's self-defense ability is very poor and it is easy to be hurt. If there is a problem in the body and it is not treated in time, hematoma is likely to occur. There are many reasons for subcutaneous hematoma, the main reason is bleeding of the tissue under the skin, so what is the cause of subcutaneous hematoma in newborns?

What is a scalp hematoma?

First, let's clarify the definition of scalp. In a broad sense, scalp refers to the soft tissue covering the outside of the skull, but a more accurate definition is: skin, subcutaneous tissue and galea aponeurotica. The so-called galea aponeurotica is a membranous structure connecting the occipital and frontal muscles. The subcutaneous tissue is composed of fat and thick, vertical fiber bundles, so the cross-section of the scalp appears to contain granular fat structure and is relatively dense. The connection between the galea aponeurotica and the periosteum, as well as the connection between the periosteum and the skull, are both relatively loose, so it is easier for the blood vessels in these loose gaps to be damaged under the action of external force (often birth trauma). In addition, the blood vessels of newborns themselves are very fragile, so scalp hematomas are relatively common. Depending on the specific location of the hematoma, it is divided into the most common subperiosteal hematoma and subgaleal hematoma, followed by subcutaneous hematoma. In clinical practice, these are often collectively referred to as scalp hematomas.

Common manifestations and treatment methods

Subcutaneous hematoma

The general cause of subcutaneous hematoma is soft tissue contusion caused by direct violence, which causes rupture and bleeding of small subcutaneous blood vessels. Because the structure of this layer is relatively dense, the bleeding range is small and limited. For the treatment of subcutaneous hematoma, first rule out more critical conditions such as intracranial hemorrhage and then apply local cold compress. Surgery is often not required to treat the hematoma. Subgaleal hematoma Subgaleal hematoma is caused by damage to small arteries and loose tissue structure under this layer. Therefore, the growing hematoma is prone to further expansion and is generally larger than subcutaneous hematoma. Hematomas are more common on the top of the head and less common on the occipital, temporal and frontal regions. The incidence of subgaleal hematoma is second only to that of subcutaneous hematoma. The treatment methods are different at different stages. The specific treatment methods are described below.

Subperiosteal hematoma

During the delivery process, the use of negative pressure suction or forceps to assist delivery can easily cause rupture of subperiosteal blood vessels and bleeding, leading to subperiosteal hematoma of the skull. Subperiosteal hematoma is absorbed slowly and easily ossifies and can easily lead to an increase in the amount of hematoma. Due to the characteristics of coagulation function and active osteoblasts in newborns, hematomas often form hyperplastic ossification tissue. After the subperiosteal hematoma ossifies, it is difficult to absorb, which not only affects the appearance but also easily affects the development of the skull. Neonatal scalp hematoma is often a subperiosteal hematoma in clinical practice. If not treated promptly, some children with subperiosteal hematoma will miss the best treatment period. This may make an originally simple treatment method more complicated. Therefore, if babies have scalp hematoma, it is best to seek medical attention before deciding whether to treat it.