title: Proptosis after hair pulling.
abstract: We describe proptosis due to a subperiosteal orbital hematoma that originated from a subgaleal bleed caused by hair pulling. A 13-year-old boy presented with a one-week history of progressive proptosis after his older sister pulled his hair during an argument. Computerized tomography showed a subgaleal hematoma and a right superior subperiosteal orbital hematoma. Progressive proptosis and compressive optic neuropathy developed, necessitating surgical evacuation with a favorable outcome.Hair pulling can result in a subgaleal bleed with extension to the orbital subperiosteal space. When managing patients with a subgaleal hematoma, this vision-threatening complication should be considered and treated accordingly.
authors.affiliation: Cincinnati Eye Institute and The University of Cincinnati College of Medicine, Department of Ophthalmology, Cincinnati, Ohio, U.S.A.
authors.forename: Chee-Chew
authors.initials: CC
authors.lastname: Yip
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: McCulley
authors.forename: Robert C
authors.initials: RC
authors.lastname: Kersten
authors.forename: Dwight R
authors.initials: DR
authors.lastname: Kulwin
mesh_terms: D000293:Adolescent; D005094:Exophthalmos / Q000209:etiology*; D018859:Hair Follicle / Q000293:injuries*; D006406:Hematoma / Q000000981:diagnostic imaging / Q000209:etiology*; D006801:Humans; D008297:Male; D019315:Retrobulbar Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology*; D012535:Scalp / Q000293:injuries*; D014057:Tomography, X-Ray Computed