Hair Braiding Triggered Rare Subperiosteal Scalp Hematoma in 10-Year-Old Boy

A 10-year-old boy arrived at an emergency department with left-sided scalp swelling that had appeared after hair braiding, and imaging of the unusual injury has now been described in a case image published in Pediatric Radiology. Initial soft-tissue ultrasound of the left scalp showed a multiloculated, avascular lesion on a panoramic longitudinal image, a finding that initially raised concern for a lymphatic malformation.

Subsequent contrast-enhanced brain MRI clarified the diagnosis. An axial T2-weighted image revealed a hemorrhagic scalp collection containing internal hematocrit levels, with signal characteristics of blood products in various stages of breakdown.

Two imaging details proved decisive. The presumed mechanism is prolonged hair traction causing disruption of periosteal and/or emissary vessels.

The authors emphasize that recognizing this uncommon entity matters because its imaging appearance can mimic vascular malformations or other scalp masses, particularly when a history of trauma is not readily apparent. In this case the braiding history was known, but the initial ultrasound appearance alone was suggestive of a malformation, and only the MRI signal characteristics and the suture-bounded distribution established the hemorrhagic nature of the lesion.

Subject of Research: A case report of a subperiosteal scalp hematoma caused by hair-braiding traction in a 10-year-old boy, diagnosed by MRI after ultrasound suggested a lymphatic malformation.

Article Title: Subperiosteal hematoma following hair braiding in a child: an unusual traction-related scalp injury

Article References: Derinkuyu, D., & Derinkuyu, B. E. (2026). Subperiosteal hematoma following hair braiding in a child: an unusual traction-related scalp injury. Pediatric Radiology. https://doi.org/10.1007/s00247-026-06818-5

Image Credits: AI Generated

DOI: 10.1007/s00247-026-06818-5

Keywords: subperiosteal hematoma, hair braiding, traction injury, scalp swelling, pediatric radiology, MRI, ultrasound, subgaleal hemorrhage, calvarial sutures, lymphatic malformation, case report, emergency department