Cephalhematoma

September 14, 2005
Robert P. Blereau, MD

A right parietal cephalhematoma was first noted on this 2-week-old girl 2 days after her birth. Robert P. Blereau, MD of Morgan City, La, explains that a cephalhematoma is caused by bleeding under the outer periosteum of a newborn's skull bone, usually the parietal bone, and becomes evident as a swelling by day 2 or 3 after delivery. The swelling is confined to the involved bone and, therefore, does not go past the suture lines or the midline of the skull.

A right parietal cephalhematoma was first noted on this 2-week-old girl 2 days after her birth. Robert P. Blereau, MD of Morgan City, La, explains that a cephalhematoma is caused by bleeding under the outer periosteum of a newborn's skull bone, usually the parietal bone, and becomes evident as a swelling by day 2 or 3 after delivery. The swelling is confined to the involved bone and, therefore, does not go past the suture lines or the midline of the skull.

A cephalhematoma is believed to occur from the compression or shearing forces exerted on the head as it descends through the birth canal. Underlying skull fractures are present in 5% to 25% of neonates with this condition1; all resolve completely and spontaneously without sequelae, usually by 6 to 8 weeks of age.

Dr Blereau warns that treatment with needle aspiration is contraindicated because of the possibility of introducing an infection. The major differential diagnosis is caput succedaneum (edema of the presenting part of the scalp), which, unlike a cephalhematoma, is present at birth and may extend beyond the suture lines or midline of the skull.

REFERENCE:1. Oski FA. Principles and Practice of Pediatrics. 2nd ed. Philadelphia: JB Lippincott Co; 1994:2044.