A cephalohaematoma is a hemorrhage of blood between the skull and the periosteum of any age human, including a newborn baby secondary to rupture of blood vessels crossing the periosteum. Because the swelling is subperiosteal , its boundaries are limited by the individual bones, in contrast to a caput succedaneum. Swelling appears after days after birth. If severe the child may develop jaundice , anemia or hypotension. In some cases it may be an indication of a linear skull fracture or be at risk of an infection leading to osteomyelitis or meningitis.
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NCBI Bookshelf. Deborah A. Raines ; Conrad Krawiec ; Sameer Jain. Authors Deborah A. Raines 1 ; Conrad Krawiec 2 ; Sameer Jain 3. A cephalohematoma is an accumulation of blood under the scalp. Specific to a cephalohematoma, small blood vessels crossing the periosteum are ruptured and serosanguineous or bloody fluid collects between the skull and the periosteum. The periosteum is the membrane that covers the outer surface of all bones. The bleeding is gradual; therefore, a cephalohematoma is not evident at birth.
Because the fluid collection is between the periosteum and the skull, the boundaries of a cephalohematoma are defined by the underlying bone. In other words, a cephalohematoma is confined to the area on top of one of the cranial bones and does not cross the midline or the suture lines.
Because the collection of blood is sitting on top of the skull and not under it, there is no pressure placed on the brain. During the process of birth, pressure on the skull or the use of forceps or a vacuum extractor rupture these capillaries resulting in a collection of serosanguineous or bloody fluid.
For unknown reasons, cephalohematomas occur more often in male than in female infants. Cephalohematoma is a minor condition that occurs during the birth process. Shearing action between the periosteum and the bone causes bleeding of the emissary and diploic veins. As the bleeding continues and fills the subperiosteal space, pressure builds, and the accumulated blood acts as a tamponade to stop further bleeding.
A comprehensive history of the labor and birth is needed to identify newborns at risk of developing a cephalohematoma. Factors that increase pressure on the fetal head and the risk of developing a cephalhematoma include:. Because of the slow nature of subperiosteal bleeding, cephalohematomas usually are not present at birth but develop hours or even days after birth. Ongoing assessment to document the appearance of a cephalohematoma is important.
Once a cephalohematoma is present, assessing and documenting changes in size is continued. The raised area cannot be transilluminated, and the overlying skin is usually not discolored or injured. Cranial sutures define the boundaries of the cephalohematoma. The parietal bones are the most common site of injury, but a cephalohematoma can occur over any of the cranial bones. There is no diagnostic test for a cephalohematoma.
Diagnosis is based on the characteristic bulge on the newborns head. Additional testing is especially warranted if the newborn's behavior changes or other problems, such as respiratory, cardiovascular, or neurological are present.
Treatment and management of a cephalohematoma are primarily observational. The mass from a cephalohematoma takes weeks to resolve as the clotted blood is slowly absorbed.
Over time, the bulge may feel harder as the collected blood calcifies. The blood then starts to be reabsorbed. Sometimes the center of the bulge begins to disappear before the edges do, giving a crater-like appearance. Aspiration is not effective because the blood has clotted.
Also, entering the cephalohematoma with a needle increases the risk of infection and abscess formation. The best treatment is to leave the area alone and give the body time to reabsorb the collected fluid. Usually, cephalohematomas do not present any problem to a newborn. The exception is an increased risk of neonatal jaundice in the first days after birth. Therefore, the newborn needs to be carefully assessed for a yellowish discoloration of the skin, sclera, or mucous membranes.
Noninvasive measurements with a transcutaneous bilirubin meter can be used to screen the infant. Parents need to observe the bulge on the newborn's head for any changes, including an increase in size during the first week following birth. Recovery from a cephalohematoma requires little action except for ongoing observation.
While seeing a bulge on a newborns head can be concerning, a cephalohematoma is rarely dangerous and resolves with no lasting consequences. Cephalohematoma is a clinical diagnosis and is usually a benign complication of delivery.
However, prior to discharge the nurse, obstetrician and the delivery nurse should educate the patient on the importance of monitoring the infant for the first week. The infant should be observed for any behavior change, feeding difficulties, emesis and failure to thrive. The majority of infants have an uneventful recovery.
To access free multiple choice questions on this topic, click here. This book is distributed under the terms of the Creative Commons Attribution 4. Turn recording back on. National Center for Biotechnology Information , U. StatPearls [Internet]. Search term. Cephalohematoma Deborah A. Author Information Authors Deborah A. Affiliations 1 Univ at Buffalo. Introduction A cephalohematoma is an accumulation of blood under the scalp.
Pathophysiology Cephalohematoma is a minor condition that occurs during the birth process. History and Physical A comprehensive history of the labor and birth is needed to identify newborns at risk of developing a cephalohematoma.
Factors that increase pressure on the fetal head and the risk of developing a cephalhematoma include: Long labor. Evaluation There is no diagnostic test for a cephalohematoma.
Enhancing Healthcare Team Outcomes Cephalohematoma is a clinical diagnosis and is usually a benign complication of delivery. Questions To access free multiple choice questions on this topic, click here.
References 1. Spatulas for entrapment of the after-coming head during vaginal breech delivery. Occipital mass in antenatal sonography. J Neonatal Perinatal Med. Korean J Neurotrauma. Neonatal complications among infants delivered by vacuum extraction in relation to characteristics of the extraction.
Infected cephalohematomas and underlying osteomyelitis: a case-based review. Childs Nerv Syst. Early diagnosis and treatment of growing skull fracture.
Neurol India. Watchko JF. Identification of neonates at risk for hazardous hyperbilirubinemia: emerging clinical insights. North Am. Parker LA. Part 1: early recognition and treatment of birth trauma: injuries to the head and face. Adv Neonatal Care. Vacuum-assisted vaginal delivery. Am Fam Physician. In: StatPearls [Internet]. In this Page. Related information. Similar articles in PubMed.
They are bound between the periosteum and cranium, and therefore cannot cross sutures. Being bound by a suture line distinguishes them from subgaleal hematoma , which can cross sutures. The incidence increases with ventouse and forceps extraction and thus more common in primiparous mothers. There may be a greater male predilection 4.
Cefalohematoma calcificado persistente: a propósito de un caso
Aka: Cephalhematoma , Cephalohematoma. These images are a random sampling from a Bing search on the term "Cephalhematoma. Search Bing for all related images. Started in , this collection now contains interlinked topic pages divided into a tree of 31 specialty books and chapters.
Skip to search form Skip to main content You are currently offline. Some features of the site may not work correctly. Ares Mateos Published Medicine. Title: Persistent calcified cephalhematoma: a case report Cephalhematomas are birth trauma-related injuries affecting 1.