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Neuroradiology Case of the Week

Case 365

November 2008

Hisao Nakamura, MD and Per-Lennart Westesson, MD, PhD, DDS

Clinical Presentation: Patient is an 11-year-old male who has a boggy scalp and worsening headache. He has a prior history of his hair being pulled back.

Imaging Findings: Scalp hematoma.

Diagnosis: Scalp Hematoma

Discussion: Laboratory tests demonstrated Factor V was low. Factor V is a protein of the coagulation system. Deficiency leads to predisposition for hemorrhage. The presence of a scalp hematoma has a strong association with an underlying skull fracture. The role of CT is to detect fractures. In this present case, considering the minor trauma and no evidence of fracture, the physician was looking for a blood abnormality.

References:

1. http://en.wikipedia.org/wiki/Factor_V