) or cephalhaematoma
) is a hemorrhage
between the skull
and the periosteum
of 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 chignon
The usual causes of a cephalhematoma are a prolonged second stage of labor
or instrumental delivery, particularly ventouse
If severe the child may develop jaundice
. In some cases it may be an indication of a linear skull fracture
or be at risk of an infection leading to osteomyelitis
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 relatively softer centre so that it appears as a 'depressed fracture'.
Cephalhematoma should be distinguished from another scalp bleeding called Subgaleal hemorrhage (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.
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.