Subaponeurotic or subgaleal fluid collections in infancy: an unusual but distinct cause of scalp swelling in infancy

Experiences of Parents Caring for Infants with Rare Scalp Mass as Identified through a Disease-Specific Blog

“…The average age at onset of the DSFC in this series (8.75 weeks) is very similar to that previously reported (7.5 weeks). 21 However, the average age at resolution in our series (16.3 weeks) was quite a bit older compared with the series described by Vaibhav et al 21 (10 weeks). Determination of "resolution" may reflect considerable subjectivity among appraising parents or physicians.…”

“…We also provide an image of an infant with DSFC to support recognition of this entity (Figure 2). We concur with Vaibhav et al 21 that though DSFC can be diagnosed clinically without the use of radiologic investigation, each case must be evaluated individually and appropriate diagnostic tests should be ordered if there are any concerns. In such instances, providers should consider the possible harms of any test when weighing which test is most appropriate.…”

“…These patients presented with "nontender, soft, mobile and fluctuant scalp swellings," all of which resolved within 24 weeks, with "no long-term sequelae." Vaibhav et al 21 presented 4 additional cases and reiterated the points noted in earlier publications: the entity is little-known, has a mean age at appearance of 7 weeks and mean age at resolution of 10 weeks, can be diagnosed clinically, and has no detrimental implications for subsequent development.…”

“…Parental distress often was compounded by the lack of a clear diagnosis, multiple visits to different care providers, time delays in receiving diagnostic 21 suggest, it is reasonable to consider inflicted trauma when evaluating an infant with an unexplained scalp mass. However, knowledge of a benign diagnostic entity such as DSFC may have provided the clinician with an alternative explanation, potentially avoiding unnecessary CT scans, specialist referrals, and involvement of Child Protective Services.…”

“…Various labor and delivery practices have been implicated as possible causative agents, including the use of assistive measures such as vacuum 20 and/or scalp electrodes. 24 Vaibhav et al 21 summarized the delivery characteristics of the extant cases in the literature: instrument assistance was used in 10 of 15 cases, and vacuum assistance in 9 of the 15 cases. In our cohort, vacuum extraction was used in approximately 50% of the cases.…”