Cephalohematoma

Cephalohematoma is a type of hematoma that occurs in the neonatal period. It is characterized by a collection of blood between the periosteum and the skull bone of a newborn baby. This condition is typically caused by birth trauma, particularly from the use of forceps or vacuum extraction during delivery.

Presentation

Cephalohematoma presents as a swelling on the baby's head, which is usually firm and well-defined. Unlike caput succedaneum, cephalohematoma does not cross the suture lines of the skull. The swelling may not be immediately apparent at birth but can develop within the first few hours to days of life.

Causes

The primary cause of cephalohematoma is birth trauma. This can occur due to prolonged labor, the use of birth-assisting tools such as forceps or vacuum extraction, or the delivery of a large baby. The pressure exerted on the baby's head during these situations can cause blood vessels to rupture, leading to the accumulation of blood between the periosteum and the skull.

Diagnosis

Diagnosis of cephalohematoma is primarily clinical, based on the physical examination of the newborn. In some cases, an ultrasound may be performed to confirm the diagnosis and rule out other conditions such as subgaleal hemorrhage.

Complications

While cephalohematoma is generally a benign condition, it can lead to complications such as jaundice, anemia, and infection. Jaundice occurs due to the breakdown of red blood cells within the hematoma, leading to an increase in bilirubin levels. Anemia can result from significant blood loss, and infection can occur if the hematoma becomes infected.

Treatment

Most cases of cephalohematoma resolve on their own without the need for intervention. Observation is usually sufficient, and the swelling typically subsides over a period of weeks to months. In cases where jaundice develops, phototherapy may be required to reduce bilirubin levels. If an infection occurs, appropriate antibiotic treatment is necessary.

Prognosis

The prognosis for cephalohematoma is generally good. Most cases resolve without any long-term effects. However, it is important to monitor the newborn for any signs of complications and provide appropriate treatment if necessary.

See also

• Caput succedaneum
• Subgaleal hemorrhage
• Neonatal jaundice
• Birth trauma