Airway obstruction resulting from massive subgaleal hematoma caused by superficial temporal artery injuries in an adult patient with liver cirrhosis

Abstract

Subgaleal hematoma, characterised by blood accumulation between the galea aponeurosis and the periosteum, is rarely reported in adults. A man with liver cirrhosis experienced airway obstruction secondary to an extensive subgaleal hematoma due to superficial temporal artery injuries. Within 6 hours after injury, swelling of the patient's head and neck was noted, which was associating with inspiratory wheezing and paradoxical breathing, thus necessitating emergency intubation. The branches of the superficial temporal artery were identified as the bleeding source via angiography. Subsequently, endovascular embolisation was successfully performed. This case highlights a rare association between airway obstruction and subgaleal hematoma, originating from injuries of the superficial temporal artery in an adult patient with severe coagulopathy. Airway obstruction was secondary to the hematoma progression into the facial and neck regions. It is crucial to identify and address alternative bleeding sources if conservative treatments or initial interventions for subgaleal hematomas are proven ineffective.

Keywords: Adult intensive care; Interventional radiology; Trauma.