Cephalohematoma

Infant who

had a forceps delivery 3 months ago. AP radiograph of the skull shows bilateral calcified cresenteric areas in the subcutaneous tissues on the top of the skull that do not cross suture lines.The diagnosis was bilateral calcified cephalohematomas.

pediatricimaging.org • CC-by-nc-sa 4.0

Diagram of

the infant scalp showing the locations of the common hematomata of the scalp in relation the layers of the scalp. Newborn Scalp Hematomata

Wikipedia • CC-BY-SA-3.0

Radiopaedia • CC-by-nc-sa 3.0 • de

Cephalohematomas are traumatic subperiosteal hematomas of the skull that are usually caused by birth injury. They are bound between the periosteum and cranium, and therefore cannot cross sutures. Being bound by a suture line distinguishes them from subgaleal hematoma, which can cross sutures.

Epidemiology

Cephalohematomas occur in 1-2% of live births. The incidence increases with ventouse and forceps extraction and thus more common in primiparous mothers. There may be a greater male predilection .

Radiographic features

Cephalohematomas are clinically diagnosed and infrequently imaged. They can be unilateral or bilateral, and appear as subgaleal fluid collections bounded by suture lines. In the setting of craniosynostosis, the blood products are able to traverse the affected suture . By 2-3 weeks, they may become peripherally calcified . The hematoma usually resolves in 2-3 months.