II. Pathophysiology

  1. Potential space between skull periosteum to scalp galea
    1. Extends posteriorly from orbital ridges to occiput
    2. Extends laterally to ears
  2. Blood accumulates in this potential space

III. Risk factors

  1. Repeated use of vacuum extractor
  2. Coagulopathy

IV. Symptoms

  1. Insidious Hematoma growth
    1. May extend to involve entire calvarium
    2. Develops over hours to days

V. Signs

  1. Scalp pits as if edematous
  2. Periorbital or auricular Ecchymosis
  3. Hematoma crosses Suture lines

VI. Management

  1. Vigilant observation
  2. Scalp pressure dressing
  3. Transfusion
  4. Phototherapy

VII. Complications

  1. Hemorrhagic Shock
  2. Infection

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