Observational Case Analysis of Neonates With Large Cephalohematoma

Abstract

IntroductionCephalohematomas in the newborn period are related to the accumulation of blood between the bone and periosteum as a result of a series of adverse conditions during labor. The optimal approach to cephalohematoma cases is still unclear. In this study, we aimed to present the follow-up data of 94 newborns with a cephalohematoma size of >50 mm and a higher risk of ossification. MethodsThis is a single-center, non-randomized, prospective, observational study conducted from May 2014 to May 2019. Records of all newborns with cephalohematoma were reviewed in terms of gender, birth weight, cephalohematoma region, transverse/vertical diameter of the lesion, delivery method, and rate of ossification. ResultsThe girl-to-boy ratio was 53/41, with a mean gestational age of 38.3±1.4 weeks and a mean birth weight of 3,300±800 grams. The mean transverse/vertical diameter of cephalohematoma was 59±9 mm. Cephalohematoma was completely resorbed at the first-month control visits in 72 (76.6%) cases, whereas nine (9.57%) had an ossified cephalohematoma. The ossification was completely or partially resorbed in these at the end of the one-year follow-up. ConclusionHence, we suggest that an early intervention is not required in the routine treatment of cases with hematomas with a size of >50 mm in size unless otherwise stipulated with clinical indications.

A case of chronic ossified hematoma presented as a skull lesion: A literature review on two rare conditions, cephalhematoma, and intradiploic hematoma

“… 2 When found at older ages, OCH could be mistaken for other ossified skull lesions. 1 OCH can resemble a depressed fracture that requires different management. 6 The pericranium covers the hematoma and, in older patients, causes the ossified outlining layer to reach the external table, which could be not distinguished with histological examinations.…”

“…Still, in OCH patients, due to the excellent contour of the underlying skull, there is no need for cranioplasty, and an en‐block excision could be obtained with a simple craniectomy as we did in our case. 1 , 3 Therefore, we suggest craniectomy with en‐bloc organized hematoma removal as the treatment of choice for OCH. High speed‐drill could be used to smoothen the borders of the underlying bone to give the skull a proper shape, as we did in this case.…”

A case of chronic ossified hematoma presented as a skull lesion: A literature review on two rare conditions, cephalhematoma, and intradiploic hematoma

“…According to previous reports, approximately 20 percent of cephalhematomas undergo calcification, but most resolve after conservative follow-up (2). When found at older ages, OCH could be mistaken for other ossified skull lesions (1). OCH can resemble a depressed fracture that needs different management (6).…”

Traumatic Birth Injury in a Term Neonate

“…Extracranial birth injuries of the head are relatively commonplace in labor and delivery. Although frequently benign, severe cases can be potentially detrimental to the health of the neonate [1][2][3][4][5]. Two variations of extracranial birth injury relevant to the present case are cephalohematoma and caput succedaneum.…”

“…Patients with cephalohematoma, as well as those with subgaleal hemorrhage, are at an increased risk for hyperbilirubinemia, apnea, and infection [3]. Most cases of cephalohematoma spontaneously and completely resolve within one month, but some are complicated by ossification, calcification, or the formation of a central depression [4,5]. Benign cases of cephalohematoma are often simply observed, while severe cases are managed symptomatically or with surgical excision [4,6].…”