Cephalohematoma in newborns is a collection of blood between the baby's scalp and the skull bone.
Understanding Cephalohematoma
A cephalohematoma occurs when small blood vessels rupture during labor and delivery, leading to a pooling of blood beneath the periosteum, the membrane that covers the skull bone. Unlike caput succedaneum (another type of scalp swelling in newborns), cephalohematoma is confined to the boundaries of individual cranial bones and does not cross suture lines.
Key Characteristics:
- Location: Between the periosteum and the skull bone.
- Cause: Rupture of blood vessels during birth.
- Appearance: A firm, raised bump on the baby's head, often appearing a few hours after birth.
- Suture Lines: Does not cross suture lines (the junctions between the skull bones).
- Timing: May not be immediately apparent at birth, often developing hours later.
Causes
The primary cause of cephalohematoma is the pressure exerted on the baby's head during the birthing process. Factors that increase the risk include:
- Prolonged labor: Extended time in the birth canal.
- Instrumental delivery: Use of forceps or vacuum extraction.
- Large baby: Larger head size can increase pressure.
Diagnosis and Treatment
A physical examination is usually sufficient to diagnose cephalohematoma. In some cases, particularly if there are concerns about a skull fracture, an X-ray may be performed.
Treatment is typically conservative. Most cephalohematomas resolve on their own over weeks to months.
- Observation: Monitoring the size and consistency of the swelling.
- Avoidance of pressure: Being gentle when handling the baby's head.
- Rare cases: If the hematoma is very large, or if there are signs of infection, further intervention may be needed (though extremely rare).
Potential Complications
While most cephalohematomas resolve without complications, potential issues include:
- Jaundice: Breakdown of the pooled blood can lead to increased bilirubin levels and jaundice.
- Infection: Rarely, the hematoma can become infected.
- Ossification: In rare cases, the hematoma can become calcified, leaving a hard lump on the head.
Comparison with Caput Succedaneum
| Feature | Cephalohematoma | Caput Succedaneum |
|---|---|---|
| Location | Beneath periosteum, over skull bone | Above periosteum, in the scalp tissue |
| Crosses Sutures? | No | Yes |
| Timing | Appears hours after birth | Present at birth |
| Contents | Blood | Fluid |
| Resolution | Weeks to months | Days |
In summary, cephalohematoma is a birth injury involving blood collection beneath the scalp, usually resolving without intervention, but requiring monitoring for potential complications.
