Chronic expanding hematoma

Two cases of chronic expanding hematoma are presented. Although the location and presentation vary, chronic expanding hematoma has a distinct histopathologic pattern. A diagnosis of neoplasm is suggested by its slow growth pattern. The criteria for their formation are incompletely understood, and in one case, a hematoma occurred despite apparent adequate drainage. Computed tomography is helpful in distinguishing chronic expanding hematoma from other soft-tissue masses.     

Retrobulbar hematoma and blepharoplasty

Retrobulbar hematoma leading to visual impairment is a rare but serious complication associated with elective blepharoplasty. A review of the literature addressing etiology, prevention, and management is presented. Removal of anterior orbital fat associated with traction and rupture of vessels within posterior orbital fat is currently most strongly supported as the cause of retrobulbar hematoma after blepharoplasty. Optic nerve ischemia is identified as the likely cause of visual impairment. Specific recommendations for avoidance and management of acute retrobulbar hematoma are offered. Recent background animal and human research is summarized.     

Postoperative hypertension as an etiological factor in hematoma after rhytidectomy. Prevention with chlorpromazine.

Our experience strongly implicates postoperative "reactive hypertension" as a major etiological factor in hematoma formation in the face lift patient. This autonomic lability to post-surgical and emotional stress may be prevented and treated by the appropriate and timely administration of chlorpromazine.     

Multi-component model of intramural hematoma

A novel multi-component model is introduced for studying interaction between blood flow and deforming aortic wall with intramural hematoma (IMH). The aortic wall is simulated by a composite structure submodel representing material properties of the three main wall layers. The IMH is described by a poroelasticity submodel which takes into account both the pressure inside hematoma and its deformation. The submodel of the hematoma is fully coupled with the aortic submodel as well as with the submodel of the pulsatile blood flow. Model simulations are used to investigate the relation between the peak wall stress, hematoma thickness and permeability in patients of different age. The results indicate that an increase in hematoma thickness leads to larger wall stress, which is in agreement with clinical data. Further simulations demonstrate that a hematoma with smaller permeability results in larger wall stress, suggesting that blood coagulation in hematoma might increase its mechanical stability. This is in agreement with previous experimental observations of coagulation having a beneficial effect on the condition of a patient with the IMH.