Subgaleal haematoma extending into the orbit following blunt head trauma as a cause of permanent blindness: A case illustrated review

Abstract

Concurrent occurrence of subgaleal haematoma (SGH) and orbital subperiosteal haematoma (OSPH) is an unusual post-traumatic phenomenon. It is especially seen in cases of massive SGH. This report is a review, illustrated with a personal clinical experience, of this clinical disease association. Extensive literature review using the PubMed search engine for all cases of blindness from SGH and OSPH in the English language was conducted for this report. Vision-threatening complications of massive traumatic SGH that is associated with OSPH are rare but well described. The resulting orbital bleed most commonly involves the extraconal orbital roof. It is essentially an orbital epidural haematoma. Its aetiopathogenesis is that of an orbital space occupying lesion (SOL) causing clinical evidence of raised intraorbital pressure (IOP) including chemosis, proptosis, ophthalmoplegia, exposure keratopathy and orbital cellulitis and blindness. The visual impairment is usually temporary and responds well to prompt intraorbital decompression. However, permanent blindness ensues if suboptimal treatment including missed diagnosis and or delayed treatment is offered.