II. Epidemiology
- Incidence: 0.2 to 2.5% of live births
III. Causes
- Prolonged labor
- Instrumented delivery (e.g. forceps)
IV. Pathophysiology
- Rupture of blood vessels between skull and periosteum
- Results in subperiosteal blood collection
- Bleeding limited by Suture lines
V. Signs
- Cephalhematoma does not cross Suture lines
- Well-demarcated, fluctuant swelling
- Most commonly occurs over Parietal Bone
- No overlying Skin Discoloration
- Appears by day 2-3 of life and may worsen over the first few days
- May take months to resolve completely
VI. Differential Diagnosis
- Cranial Meningocele (Occipital Cephalhematoma)
- Pulsates, and increased pressure on crying
VII. Associated Conditions
- Linear Skull Fracture
- See Skull Fracture from Birth Trauma
- Now rare, but previously accompanied Cephalohematoma in 5 to 20% of cases (likely related to reduced use of forceps)
VIII. Complications of severe Cephalhematoma
IX. Radiology
- Indications for Skull XRay or CT Head
- CNS signs
- Large Cephalhematoma
- Difficult delivery
- Findings
- Tangential view of Cephalhematoma
- Homogenous soft tissue density
- Sharply demarcated convex outer border
- Over time border develops fine calcified rim
- Skull Fracture may be associated finding
- Tangential view of Cephalhematoma
X. Course
- Resolves over 2 weeks to 3 months
- Residual calcification may occur in 1% of cases
XI. Management
- Observation in uncomplicated cases
- Significant blood accumulation therapy
- Transfusion
- Phototherapy
- Fracture
XII. References
- Gabbe (1996) Obstetrics, Churchill-Livingstone, p.661-2
- Behrman (2000) Nelson Pediatrics, Saunders, p. 489
- Weintraub (2000) Otolaryngol Clin North Am 33:1171-89 [PubMed]
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| Definition (NCI_FDA) | A subperiosteal hemorrhage limited to the surface of one cranial bone, a usually benign condition seen in the newborn as a result of bone trauma. |
| Definition (NCI) | A subperiosteal hemorrhage limited to the surface of one cranial bone. |
| Definition (NCI) | A subperiosteal hemorrhage limited to the surface of one cranial bone, a usually benign condition seen in the newborn as a result of bone trauma. |
| Concepts | Injury or Poisoning (T037) |
| ICD10 | P12.0 |
| SnomedCT | 83095000, 206200000 |
| English | Cephalhaematoma due to birth injury, Cephalhematoma due to birth injury, cephalohematoma (diagnosis), cephalohematoma, Cephalhematoma due to birth trauma, Fetal cephalhaematoma, Foetal cephalhaematoma, cephalohaematoma, Fetal Cephalhematoma, Cephalohematoma due to birth trauma, CEPHALOHEMATOMA, Cephalohematoma, Fetal cephalhematoma, Cephalohaematoma, Cephalhaematoma, Cephalhaematoma due to birth trauma, Cephalhematoma, Cephalhematoma due to birth trauma (disorder), Fetal cephalhematoma (disorder), cephalhaematoma, cephalhematoma |
| Italian | Cefaloematoma |
| French | Céphalohématome, Céphalhématome |
| Portuguese | Cefaloematoma, Cefalematoma |
| Japanese | 頭血腫, ﾄｳｹｯｼｭ |
| German | Kephalhaematom durch Geburtsverletzung, Kephalhaematom |
| Czech | Cefalohematom, Kefalohematom |
| Korean | 출산 손상으로 인한 머리혈종 |
| Hungarian | Cephalohaematoma, Cephalhaematoma |
| Spanish | cefalohematoma debido a traumatismo obstétrico (trastorno), cefalohematoma por traumatismo obstétrico (trastorno), cefalohematoma debido a traumatismo obstétrico, cefalohematoma por traumatismo obstétrico, cefalohematoma fetal (trastorno), cefalohematoma fetal, cefalohematoma, Cefalohematoma |
| Dutch | Cefaalhematoom door geboortetrauma, cefaalhematoom |
