Cephalhematoma

A cephalhematoma (American English) or cephalhaematoma (British English) is a hemorrhageof bloodbetween the skulland the periosteumof a newborn babysecondary to rupture of blood vessels crossing the periosteum. Because the swelling is subperiostealits boundaries are limited by the individual bones, in contrast to a chignon.

Image:Scalp hematomas.jpg

Causes

The usual causes of a cephalhematoma are a prolonged second stage of laboror instrumental delivery, particularly ventouse.

Symptoms

If severe the child may develop jaundice, anemiaor hypotension. In some cases it may be an indication of a linear skull fractureor be at risk of an infection leading to osteomyelitisor meningitis.

The swelling of a Cephalhematoma takes weeks to resolve as the blood clot is slowly absorbed from the periphery towards the centre. In time the swelling hardens (calcification) leaving a a relatively softer centre so that it appears as a 'depressed fracture'.

Cephalhematoma should be distinguised from another scalp bleeding called Subgaleal hemorrahge(also called Subaponeurotic Hemorrhage) which is blood between the scalp and skull bone (above the periosteum) and is more extensive. It is more prone to complications especially anemia and bruising.

Management

No laboratory studies usually are necessary. Skull Xray or CT scanning is used if neurological symptoms appear. Usual management is mainly observation. Transfusion and phototherapy are necessary if blood accumulation is significant. Aspiration is more likely to increase the risk of infection. The presence of a bleeding disorder should be considered. Skull radiography or CT scanning is also used if concomitant depressed skull fracture is a possibility.

See also

• Cephal
• Hematoma
• Subgaleal hemorrhage
• Caput succedaneum

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It uses material from the Wikipedia article Cephalhematoma.